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内镜套胃塑造与减肥的生活方式改变:一个真实世界的成本效益研究
Lauren Donnangelo1, Sanjay R V Gadi2, Daniel Maselli1
1Department of Gastroenterology, True You Weight Loss, Cary, NC 27513, United States.
World journal of gastrointestinal surgery
|November 3, 2025
概括
与生活方式修改 (LM) 相比,内镜套肠胃整形术 (ESG) 是一种成本效益高的肥胖治疗方法. 这项研究发现,ESG收益显著的质量调整寿命年 (QALYs) 以每QALY的低成本,支持更广泛的保险覆盖.
科学领域:
- 腹部外科 腹部外科
- 卫生经济学 卫生经济学
- 肥胖管理 肥胖管理
背景情况:
- 肥胖影响了42%的美国成年人,造成了巨大的经济成本.
- 内镜套胃形成术 (ESG) 是一项FDA授权的程序,其安全性和有效性已得到证实.
- 在现实肥胖患者中,ESG与生活方式改变 (LM) 的成本效益尚未得到充分证实.
研究的目的:
- 与LM相比,接近ESG的成本效益.
- 利用了860名美国成年人的现实数据集,这些成年人患有I-III类肥胖症,正在接受ESG治疗.
主要方法:
- 采用了6个状态的马尔科夫模型 (健康体重,超重,I-III类肥胖,死亡).
- 临床管理小组使用了基于文献的过渡状态和专家意见.
- 模型纳入了健康状态的公用事业,不良事件的不良事业和并发症的发生率.
主要成果:
- 对于ESG与LM的基础情况增量成本效益比率 (ICER) 为每QALY5904美元.
- 敏感性分析证实了ESG的成本效益,上限ICER低于10万美元/QALY门.
- 在敏感性分析中,肥胖类公用事业对ICER的影响最大.
结论:
- 与LM相比,ESG在所有肥胖类别中都具有压倒性的成本效益.
- 付款人应该考虑扩大ESG的覆盖范围,以改善患者的治疗结果并降低长期医疗保健成本.
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