Impact of Bariatric Surgery on Medication Costs and Disease Burden in Obesity: A Retrospective Cohort Study

Obesity is a highly prevalent chronic disease associated with substantial morbidity, multiple comorbidities, and a significant burden on healthcare systems. Metabolic bariatric surgery (MBS) is effective in achieving weight loss and improving obesity-related comorbidities, potentially reducing pharmacotherapy requirements and overall disease burden. Nevertheless, evidence from Portuguese real-world clinical practice remains limited. Therefore, this study aimed to provide the first Portuguese evaluation of the impact of MBS on pharmacotherapy-related healthcare costs and on the prevalence and burden of obesity-associated comorbidities. A retrospective cohort study was conducted. Annual pharmacotherapy costs and changes in the prevalence and burden of obesity-associated comorbidities, measured using Years Lived with Disability (YLD), were compared before and 3 years after surgery. Three years after MBS, the mean annual pharmacotherapy cost per patient decreased by €56.11 (p < 0.05). Reductions in medication costs were observed for antihypertensive, lipid-lowering, and antidiabetic therapies (all p < 0.05). The prevalence of obesity-related comorbidities also decreased, particularly hypertension, type 2 diabetes mellitus, dyslipidemia and asthma (all p < 0.05). Correspondingly, the estimated burden of disease decreased, with mean YLD declining from 0.022 before surgery to 0.014 3 years after surgery (p < 0.05). Over 3 years of follow-up, MBS was associated with reductions in medication costs, the prevalence of obesity-related comorbidities, and overall disease burden. These findings highlight the clinical and economic benefits of MBS in the management of obesity and its associated conditions over the medium term. Metabolic bariatric Surgery reduced mean annual pharmacotherapy costs by €56.11 per patient over a 3-year follow-up. Significant reductions in medication costs were observed for antihypertensive, lipid-lowering, and antidiabetic therapies after metabolic bariatric surgery. The prevalence of dyslipidemia, hypertension, type 2 diabetes mellitus and asthma decreased by 32%, 21%, 16% and 5%, respectively, three years after surgery. Mean Years Lived with Disability (YLD) decreased by 36%, from 0.022 preoperatively to 0.014 at 3 years, indicating a substantial reduction in obesity-related disease burden.