Gap Between Evidence and Patient Access: Policy Implications for Bariatric and Metabolic Surgery in the Treatment of Obesity and its Complications

Pharmacoeconomics. 2015 Jul;33(7):629-41. doi: 10.1007/s40273-015-0302-y.


Despite consistently supportive evidence of clinical effectiveness and economic advantages compared with currently available non-surgical obesity treatments, patient access to bariatric and metabolic surgery (BMS) is impeded. To address this gap and better understand the relationship between value and access, the objectives of this study were twofold: (i) identify the multidimensional barriers to adoption of BMS created by clinical guidelines, public policies, and health technology assessments; and, most importantly, (ii) develop recommendations for stakeholders to improve patient access to BMS. Updated public policies focused on treatment and clinical guidelines that reflect the demonstrated advantages of BMS, patient education on safety and effectiveness, updated reimbursement policies, and additional data on long-term BMS effectiveness are needed to improve patient access.

Publication types

  • Review

MeSH terms

  • Bariatric Surgery / economics*
  • Bariatric Surgery / methods
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / economics
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / surgery*
  • Health Policy / economics*
  • Health Services Accessibility / economics*
  • Health Services Accessibility / statistics & numerical data
  • Humans
  • Obesity / complications
  • Obesity / economics
  • Obesity / epidemiology
  • Obesity / surgery*