Abstract:This
 paper attempts to quantify the social, private, and public-finance 
values of reducing obesity through pharmaceutical and medical 
interventions. We find that the total social value of bariatric surgery 
is large for treated patients, with incremental social 
cost-effectiveness ratios typically under $10,000 per life-year saved. 
On the other hand, pharmaceutical interventions against obesity yield 
much less social value with incremental social cost-effectiveness ratios
 around $50,000. Our approach accounts for: competing risks to life 
expectancy; health care costs; and a variety of non-medical economic 
consequences (pensions, disability insurance, taxes, and earnings), 
which account for 20% of the total social cost of these treatments. On 
balance, bariatric surgery generates substantial private value for those
 treated, in the form of health and other economic consequences. The net
 public fiscal effects are modest, primarily because the size of the 
population eligible for treatment is small. The net social effect is 
large once improvements in life expectancy are taken into account.
by Pierre-Carl Michauda,  , Dana P. Goldmanb, Darius N. Lakdawallab, Yuhui Zhengc and Adam H. Gaileyd
, Dana P. Goldmanb, Darius N. Lakdawallab, Yuhui Zhengc and Adam H. Gaileyd 
a Université du Québec à Montréal & RAND, Canada 
b University of Southern California and RAND, United States 
c Harvard University, United States 
d RAND Corporation, United States
Journal of Health Economics via Elsevier Science Direct www.ScienceDirect.com
Volume 31, Issue 4, July 2012, Pages 630–643
Keywords: Obesity; Health spending; Ageing; Microsimulation
 
 
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