P4037 - The Cost-Effectiveness of Endoscopic Gastric Sleeve: A Systematic Review of Available Evidence

Adrian Riva-Moscoso, MD¹, Eduardo Sevilla-Acosta, MD¹, Euler Altamirano-Farfan, MS², Diego Izquierdo-Veraza, MD³, Dalton A. Norwood, MD⁴, Eleazar E.. Montalvan-Sanchez, MD³, Andres Chaponan-Lavalle, MD¹, Karla Hernandez Randich, MD¹, Jonathan Montrose, DO³, Mirian Ramirez-Rojas, MLIS⁵, Renato Beas, MD^6
1Universidad Peruana de Ciencias Aplicadas, Lima, Lima, Peru; ²Universidad Nacional de San Agustín de Arequipa, Arequipa, Arequipa, Peru; ³Indiana University School of Medicine, Indianapolis, IN; ⁴UAB Minority Health and Health Equity Research Center, The University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL; ⁵Ruth Lilly Medical Library, Indiana University School of Medicine, Indianapolis, IN; ⁶Indiana University, Indianapolis, IN

Introduction: Endoscopic Sleeve Gastroplasty (ESG) has emerged recently as a novel minimally invasive technique aimed to reduce the stomach volume. The clinical effectiveness of this procedure has already been well established; however, its cost-effectiveness remains unclear. This study aims to provide a systematic review of all the evidence available on the cost-effectiveness of ESG, aiding healthcare decisions regarding its viability as a therapeutic option.

Methods: A comprehensive search of multiple databases including Ovid MEDLINE, Ovid EMBASE, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, SciELO and Web of Science was conducted from inception to May 2023 for all published studies and conference abstracts addressing cost-effectiveness or cost-effectiveness analysis of endoscopic sleeve gastroplasty compared to endoscopic bariatric procedures or lifestyle changes. No limitations were placed on study type, sample size, location, year published, age or sex of participants, or language of publication. The titles and abstracts of all the publications were screened and reviewed by two independent reviewers. Data was extracted from the selected publications into an Excel spreadsheet.

Results: The search strategy retrieved 2730 studies, 50 of them were identified for further review and five met the inclusion criteria (Figure 1). Only one of the studies was published as full text and the rest were conference abstracts. Three studies were exclusively conducted in the USA, one in the UK and one in both USA and Europe. Studies compared ESG to Intragastric Balloon (IGB), Laparoscopic Sleeve Gastrectomy (LSG), Surgical Sleeve Gastrectomy (SSG) or lifestyle modification. Three studies utilized the Markov model to estimate cost-effectiveness. The incremental cost-effectiveness ratio (ICER) in the studies ranged from (3,029 USD–131,671 USD /QALY). Four of the five concluded that ESG is more cost-effective compared to other interventions (lifestyle modification, IGB and SSG) for the treatment of adults with obesity with and without associated comorbidities (Table 1).

Discussion: Endoscopic Sleeve Gastroplasty (ESG) was found to be generally cost-effective based on our review of the best available data in the literature. However, more complete and comprehensive studies are still needed to further evaluate this intervention among the different obesity subgroups or comorbidities and compared to other novel therapies.



Disclosures:


Adrian Riva-Moscoso, MD¹, Eduardo Sevilla-Acosta, MD¹, Euler Altamirano-Farfan, MS², Diego Izquierdo-Veraza, MD³, Dalton A. Norwood, MD⁴, Eleazar E.. Montalvan-Sanchez, MD³, Andres Chaponan-Lavalle, MD¹, Karla Hernandez Randich, MD¹, Jonathan Montrose, DO³, Mirian Ramirez-Rojas, MLIS⁵, Renato Beas, MD⁶. P4037 - The Cost-Effectiveness of Endoscopic Gastric Sleeve: A Systematic Review of Available Evidence, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.