| Title: |
The value of metabolic surgery for patients with obesity and type 2 diabetes in Romania |
| Authors: |
Kovács, Gábor; Lorenzovici, László; Poiană, Cătălina; Catoi, Adriana Florinela; Duta, Ciprian; Timofte, Daniel Vasile; Coros, Marius Florin; Siménfalvi, Sándor; Farkas-Ráduly, Szabolcs; Török, Tamás; Jakab, Andrea Timea; Kacsó, Andrea; Nagy, László; Imre, László; Nagy, Dávid; Copaescu, Catalin Andu; Pana, Bogdan Cristian |
| Source: |
Frontiers in Nutrition ; volume 12 ; ISSN 2296-861X |
| Publisher Information: |
Frontiers Media SA |
| Publication Year: |
2025 |
| Collection: |
Frontiers (Publisher - via CrossRef) |
| Description: |
Background Metabolic surgery is a well-established intervention for managing severe obesity and type 2 diabetes, offering significant long-term health benefits. In Europe, procedures such as sleeve gastrectomy and Roux-en-Y gastric bypass have been shown to improve glycemic control, reduce obesity-related comorbidities, and enhance quality of life. Given the high prevalence of obesity in Romania, evaluating the cost-effectiveness of these surgical interventions is crucial for potential public funding inclusion. Methods We adapted a Central European type 2 diabetes—metabolic surgery cost-utility model using Romanian epidemiological and healthcare cost data to assess the cost-effectiveness of weight-loss surgery. The model incorporated three Body Mass Index strata (30–34.9, 35–39.9, ≥40 kg/m 2 ) and tracked outcomes over a lifetime horizon. Cost and quality-adjusted life years were evaluated for sleeve gastrectomy and Roux-en-Y gastric bypass using two costing methodologies: Diagnosis-Related Group-based reimbursement and micro-costing analysis. Scenario analyses, including threshold analysis, were conducted to validate model robustness. Results Obesity surgery was found to be a dominant strategy, yielding both cost savings and improved health outcomes across all Body Mass Index categories. The intervention led to increased life expectancy, reduced diabetes-related complications, and a significant reduction in healthcare costs. Even under conservative cost assumptions, the surgery remained cost-effective, with an Incremental Cost-Effectiveness Ratio (ICER) well within European funding thresholds. Conclusion The results support the inclusion of metabolic surgery in Romania’s public healthcare system. Expanding access could reduce long-term healthcare expenditures while improving the quality of life for individuals with obesity and type 2 diabetes. |
| Document Type: |
article in journal/newspaper |
| Language: |
unknown |
| DOI: |
10.3389/fnut.2025.1624280 |
| DOI: |
10.3389/fnut.2025.1624280/full |
| Availability: |
https://doi.org/10.3389/fnut.2025.1624280; https://www.frontiersin.org/articles/10.3389/fnut.2025.1624280/full |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.A7333744 |
| Database: |
BASE |