Medication use after bariatric surgery in a managed care cohort

Background: Bariatric surgery has been shown to provide long-term weight loss, in addition to a significant reduction in obesity-related co-morbidities. The primary aim of this study was to describe the medication use and costs within a managed care cohort after bariatric surgery. A secondary aim was to describe the use rates for other health services after bariatric surgery. Methods: This retrospective cohort study used an administrative database from a large managed care organization to examine the health outcomes in persons 6 months before and 6 months after bariatric surgery. Results: The average number of prescription claims per person decreased after surgery, from 6.93 (SD 7.16) before to 4.88 (SD 5.84) after surgery (P <.001). The average number of claims for office visits decreased from 5.52 before to 3.94 after surgery (P = .0028), and the average number of claims for outpatient visits decreased from 0.75 before to 0.40 after surgery (P <.001). However, the average number of inpatient visit claims increased after bariatric surgery, from 0.04 (SD 0.31) to 0.07 (SD 0.52) claims per person (P = .04). In the preoperative period, the paid costs for pharmacy claims were an average of $221.30 (SD $341.25). After surgery, the pharmacy paid costs decreased to an average cost of $158.90 (SD $454.13). Conclusion: Within this sample, medication use and costs decreased within 6 months of bariatric surgery. Decreases were also noted in the postoperative period in several obesity-related co-morbidities, office visits, emergency room visits, and outpatient visits; however, an increase occurred in inpatient stays after surgery.