Evidence map›Paper›PMID 41484761›Full record

ArticleObesity surgery2026

Roux-en-Y Gastric Bypass Compared to Glucagon-Like Peptide-1 Receptor Agonists is Associated with Lower Out-of-Pocket Costs in Insured Patients with Type 2 Diabetes and Obesity: A Matched Analysis Over Two Years.

Sibi Thiyagarajan, Elizabeth Wall-Wieler, Yuki Liu, Feibi Zheng, Michael Edwards

Abstract readComparative Study
In one paragraph

Article in Obesity surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Sibi ThiyagarajanDivision of Advanced GI and Bariatric Surgery, Mayo Clinic, Jacksonville, FL, USA.
Elizabeth Wall-WielerGlobal Health Economics and Outcomes Research, Intuitive Surgical (United States), Sunnyvale, CA, USA.
Yuki LiuGlobal Health Economics and Outcomes Research, Intuitive Surgical (United States), Sunnyvale, CA, USA.
Feibi ZhengGlobal Health Economics and Outcomes Research, Intuitive Surgical (United States), Sunnyvale, CA, USA.
Michael EdwardsDivision of Advanced GI and Bariatric Surgery, Mayo Clinic, Jacksonville, FL, USA. maeedw@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate two-year costs to insured patients treated with Roux-en-Y gastric bypass (RYGB) or glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for type 2 diabetes (T2D) and obesity.

methodsUsing the 2017 to 2023 Merative™ claims database, we identified adult patients with severe obesity and T2D who were treated with a RYGB or GLP-1 RAs. Patients with RYGB had no treatment with GLP-1 RAs, and those who received GLP-1 RAs therapy with tirzepatide or semaglutide for ≥ 2 years had no metabolic and bariatric surgery (MBS) procedures. The study cohorts were matched on demographics including obesity, associated medical problems, and baseline direct or out-of-pocket (OOP) costs to patients in the year prior to treatment initiation. Direct costs included those from outpatient services, inpatient admissions, and outpatient prescription filled that were paid directly by patients. We compared this cost up to two years after treatment initiation using paired t-tests.

results1012 matched RYGB and GLP-1 RAs patients were analyzed, including 35% male. At 1-year after treatment initiation, healthcare costs paid directly by patients were similar for the RYGB ($2,301) and GLP-1 RAs ($2,179) (delta = $122, p = 0.15) cohorts. From one to two years after index treatment date, OOP costs were significantly lower in the RYGB treatment group ($1,277 vs. $2,104, p < 0.01). Two years after treatment initiation, RYGB patients spent $704 less in OOP costs than similar patients treated with GLP-1 RAs medications (p < 0.01).

conclusionsDirect OOP healthcare costs were lower for RYGB compared to treatment with GLP-1 RAs two years after treatment initiation.

Indexed as

Diabetes Mellitus, Type 2Gastric BypassGlucagon-Like Peptide-1 Receptor AgonistsHealth ExpendituresHypoglycemic AgentsObesity, MorbidAdultFemaleHumansMaleMiddle AgedRetrospective StudiesGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsGlucagon-like peptide 1 receptor agonistsObesityOut-of-Pocket CostsRoux-en-Y gastric bypassType-2 Diabetes

Identifiers

PMID41484761
PMCPMC12957123

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.