Direct and indirect costs and potential cost savings of laparoscopic adjustable gastric banding among obese patients with diabetes

J Occup Environ Med. 2011 Sep;53(9):1025-9. doi: 10.1097/JOM.0b013e318229aae4.


Objective: To estimate the time to breakeven and 5-year net costs for laparoscopic adjustable gastric banding among obese patients with diabetes taking direct and indirect costs into account.

Methods: Indirect cost savings were generated by quantifying the cross-sectional relationship between medical expenditures and absenteeism and between medical expenditures and presenteeism (reduced on-the-job productivity) and simulating indirect cost savings based on these multipliers and reductions in direct medical costs available in the literature.

Results: Time to breakeven was estimated to be nine quarters with and without the inclusion of indirect costs. After 5 years, net savings increase from $26570 (±$9000) to $34160 (±$10 380) when indirect costs are included.

Conclusion: This study presented a novel approach for incorporating indirect costs into cost-benefit analyses. Application to gastric banding revealed that inclusion of indirect costs improves the financial outlook for the procedure.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absenteeism
  • Adult
  • Cost-Benefit Analysis
  • Cross-Sectional Studies
  • Diabetes Mellitus / economics*
  • Efficiency
  • Female
  • Gastroplasty / economics*
  • Health Expenditures*
  • Humans
  • Laparoscopy / economics*
  • Male
  • Obesity / complications
  • Obesity / economics*
  • Obesity / surgery