Patient Costs for Sleeve Gastrectomy Are Lower than Ozempic in Treating Obesity and Type 2 Diabetes

Edwards MA, Wall-Wieler E, Liu Y, Zheng F, Coviello A. Out-of-Pocket Costs among Commercially Insured Individuals with Type 2 Diabetes and Obesity: Comparison between Ozempic and Sleeve Gastrectomy. Ann Surg. 2024; in press.

Brown A, Chhabra KR. Your Weight and Your Wallet: Comparing Out-of-Pocket Costs of Bariatric Surgery and GLP1 Agonists. Ann Surg. 2024; in press.

This article reported data on out-of-pocket costs for bariatric surgery versus Ozempic for management of patients with morbid obesity (BMI 35 or greater) and type 2 diabetes.

The study cohort was identified using a national medical database. Included patients (n = 302 in each group) underwent sleeve gastrectomy (SG) with no use of Ozempic for two years after surgery or were treated with Ozempic for 2 years with no surgical treatment. Propensity score matching was used to provide accurate matching of patients for comparison.

The data analysis showed that out-of-pocket costs were similar for the two patient groups after 1 year ($2,267 for SG and $2,131 for Ozempic). At 2 years of follow up, costs were significantly lower for the SG group ($1,155 vs. $2,084).

The authors concluded that patient-borne costs were lower for SG.

The editorial that accompanied the article provided valuable perspectives on the components of healthcare costs. The editorialists noted that the focus of the study was on costs to the patient and did not include data on costs to the healthcare system.

Also, only patients undergoing SG were included. They noted that data on costs of Roux-en-Y gastric bypass would be valuable. Costs of GLP-1 agonists are significant, and patients may not continue treatment because of the cost burden.

They also emphasized that out-of-pocket costs of surgery are often capped because of co-insurance reimbursement, and this does not regularly occur for patients taking Ozempic. Further studies are needed to clarify the true costs to patients and the healthcare system.