Objective
The objective of this study was to compare the impact of sleeve gastrectomy (SG) and Roux‐en‐Y gastric bypass (RYGB) on overall and diabetes‐specific health care costs among patients with type 2 diabetes.
Methods
This retrospective cohort study examined patients with type 2 diabetes after SG and RYGB using data from Optum's deidentified Clinformatics® Data Mart database. The matched study group included 9608 patients who underwent SG or RYGB and were enrolled between 2007 and 2019. The primary outcomes assessed were overall and diabetes‐specific health care costs.
Results
Health care costs associated with type 2 diabetes declined substantially in the first few years following both SG and RYGB. RYGB was associated with a larger decrease in pharmacy costs, as well as type 2 diabetes‐specific office and laboratory costs. SG was associated with lower total health care costs in the first three follow‐up periods and lower acute care costs in the first 2 years after surgery.
Conclusions
In this nationwide study, patients with type 2 diabetes at baseline undergoing RYGB appear to experience a reduced need for ambulatory type 2 diabetes monitoring and reduced requirements for antidiabetes medication but, despite this, did not experience an overall medical cost–benefit in the first few years after RYGB versus SG.