Cost-effectiveness of Laparoscopic Sleeve Gastrectomy and Laparoscopic Roux-en-Y Gastric Bypass in Patients with Morbid Obesity: A Systematic Review

Obesity affects the health of people and imposes costs on them. Since there are two common treatment methods, Roux-en-Y gastric bypass (RYGB) surgery and laparoscopic sleeve gastrectomy (LSG), and there is not enough and aggregated evidence on the cost-effectiveness of these two treatment methods in patients in Iran, therefore, this study was conducted to review the studies on the cost-effectiveness of these treatment methods. This is a systematic review study. All articles published in English, which reviewed the cost-effectiveness of these two surgical methods during 2000-2017, were collected from the SCOPUS, PUBMED, MEDLINE, and EMBASE databases. The quality of these articles was evaluated by two researchers based on Grade's guidelines. The amount of body mass index (BMI) and reduced weight percentage in both methods showed the same effectiveness in weight loss. In Iran, the direct cost of RYGB services was $2991 in the public sector and $4221 in the private sector. For the LSG method, this was $1952 in the public sector and $3,177 in the private sector. ICER for the LSG method compared with the RYGB was $720 and $716 in the private and public sectors, respectively. Laparoscopic sleeve gastrectomy (LSG) is more effective than the RYGB because it has lower cost and the same effectiveness.