Piggy bank with money

The financial advantages of tailored food supplements after RYGB.

Since vitamin and mineral deficiencies are common after a Roux-en-Y Gastric Bypass (RYGB), daily food supplements are advised. In 2010, a bariatric multivitamin supplement, WLS Forte, was developed specifically for RYGB patients. An initial study including 148 RYGB patients using either WLS Forte or a standard multivitamin supplement (sMVS), showed the efficacy of WLS Forte on the nutritional status in RYGB patients, decreasing the number of postoperative deficiencies.

Besides these health benefits, it is expected that the use of WLS Forte leads to financial and logistic advantages. Therefore, the objective of this study was to analyze the cost-effectiveness of WLS Forte versus standard food supplements in the Netherlands.

Cost analysis

Data on costs within the health sector and outside the health sector was collected for 12 months, the duration of the initial RCT. Direct costs within the health sector included the costs for supplementation and all activities carried out in the hospital from diagnosis to treatment of occurring deficiencies. Indirect costs consisted of traveling expenses and production losses due to absenteeism.

Less deficiencies leading to lower overall costs

If taken consequently, the risk of developing nutritional deficiencies is 14% when WLS Forte is used, versus 30% for sMVS. As a result, WLS Forte will in general lead to lower costs for evaluation and treatment of nutritional deficiencies, and lower costs for employers due to absenteeism. Since most of the costs are related to treatment of deficiencies, on average this will result in lower total costs.

Inform, advise and check

Since multivitamin supplements are not reimbursed, patients often resort to the cheapest supplement. This study, however, shows that a cheaper sMVS is not the most effective supplement in terms of cost-effectiveness. Patients should be well informed of the adverse effects of deficiencies, advised to take the right supplementation and checked regularly. This will result in less deficiencies, leading to significantly lower overall costs from the perspective of the Dutch Health Care.

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Reference:

J. Homan, W. Schijns, I.M.C. Janssen, F.J. Berends, E.O. Aarts (2019) Adequate Multivitamin Supplementation after Roux-En-Y Gastric Bypass Results in a Decrease of National Health Care Costs: a Cost-Effectiveness Analysis. Obesity Surgery. https://doi.org/10.1007/s11695-019-03750-6

Link to full text: https://link.springer.com/article/10.1007%2Fs11695-019-03750-6