Assessing economic investment required to scale up bariatric surgery capacity in England: a health economic modelling analysis.
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Authors
Baker-Knight, James
Pournaras, Dimitri J
Mahawar, Kamal
Welbourn, Richard
Li, Yuxin
Sharma, Yuvraj
Guerra, Ines
Tahrani, Abd
Issue Date
2024-07-31
Type
Journal Article
Language
en
Keywords
COVID-19 , bariatric surgery , health economics , health policy , obesity , Wessex Classification Subject Headings::Gastroenterology
Alternative Title
Abstract
Objectives: To quantify the economic investment required to increase bariatric surgery (BaS) capacity in National Health Service (NHS) England considering the growing obesity prevalence and low provision of BaS in England despite its high clinical effectiveness. Design: Data were included for the patients with obesity who were eligible for BaS. We used a decision-tree approach including four distinct steps of the patient pathway to capture all associated resource use. We estimated total costs according to the current capacity (current scenario) and three BaS scaling up strategies over a time horizon of 20 years (projected scenario): maximising NHS capacity (strategy 1), maximising NHS and private sector capacity (strategy 2) and adding infrastructure to NHS capacity to cover the entire prevalent and incident obesity populations (strategy 3). Results: At current capacity, the number of BaS procedures and the total cost over 20 years were estimated to be 140 220 and £1.4 billion, respectively. For strategy 1, these values were projected to increase to 157 760 and £1.7 billion, respectively. For strategy 2, the values were projected to increase to 232 760 and £2.5 billion, respectively. Strategy 3 showed the highest increase to 564 784 and £6.4 billion, respectively, with an additional 4081 personnel and 49 facilities required over 20 years. Conclusions: The expansion of BaS capacity in England beyond a small proportion of the eligible population will likely be challenging given the significant upfront economic investment and additional requirement of personnel and infrastructure.
Description
Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Citation
Baker-Knight J, Pournaras DJ, Mahawar K, Welbourn R, Li Y, Sharma Y, Guerra I, Tahrani A. Assessing economic investment required to scale up bariatric surgery capacity in England: a health economic modelling analysis. BMJ Open. 2024 Jul 31;14(7):e084356.
Publisher
BMJ
License
© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Journal
BMJ open
Volume
14
Issue
7
PubMed ID
ISSN
2044-6055