{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T13:30:06Z","timestamp":1789047006546,"version":"build-2803163510"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["NIHR133099"],"award-info":[{"award-number":["NIHR133099"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["NIHR133099"],"award-info":[{"award-number":["NIHR133099"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["OBES SURG"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Endoscopic bariatric therapies, including endoscopic sleeve gastroplasty (ESG) and intragastric balloon (IGB), are emerging as less invasive alternatives to bariatric surgery. However, their economic value relative to established treatments such as bariatric surgery and pharmacotherapy remains uncertain. This study evaluated the cost-effectiveness of endoscopic bariatric therapies compared with surgery and semaglutide from a UK health system perspective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Three state-transition Markov models compared: (1) ESG versus laparoscopic sleeve gastrectomy (LSG), (2) ESG versus semaglutide, and (3) IGB versus semaglutide. The models simulated transitions between body mass index (BMI)-defined health states over a 5-year time horizon using treatment effectiveness data derived from published studies and expert input. Outcomes were expressed as quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs) from the UK National Health Service perspective. Deterministic and probabilistic sensitivity analyses explored uncertainty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For patients with class II-III obesity, LSG was cost-effective compared with ESG (\u00a310,593\/QALY). For class I and II obesity, ESG generated modestly greater QALYs than semaglutide at slightly higher cost (ICER \u00a37,267\/QALY). Semaglutide was dominant compared with IGB, producing greater health gains at lower cost. Results were most sensitive to intervention costs and assumptions regarding long-term recurrent weight gain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Endoscopic bariatric therapies may represent a cost-effective option for obesity management depending on patient characteristics and comparator treatments. LSG remains the most cost-effective intervention for severe obesity, whereas ESG may offer a cost-effective alternative to pharmacotherapy for patients with lower BMI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11695-026-08854-4","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T09:03:39Z","timestamp":1784711019000},"page":"4669-4675","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cost-Effectiveness of Endoscopic Bariatric Therapies Compared with Laparoscopic Sleeve Gastrectomy and Semaglutide"],"prefix":"10.1007","volume":"36","author":[{"given":"Nafsika","family":"Afentou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Hall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chidubem","family":"Okeke Ogwulu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Albon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janine","family":"Dretzke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malcolm","family":"Price","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Clare","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rishi","family":"Singhal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abd","family":"Tahrani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J","family":"Moore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Frew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"8854_CR1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.p523","author":"E Mahase","year":"2023","unstructured":"Mahase E. 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KC is a member of the Patient Advisory Board Novo Nordisk, Patient Advisory Board Boehringer Ingelheim and has received consulting fees from Eli Lilly. KC has membership of IHCOM board, was a Trustee ASO (resigned September 2023) and is Director of Operations Obesity UK, Chair of European Coalition of People Living with Obesity and Chair of WLSinfo Charity. Abd Tahrani (AT) has received funding from industry. At the time of writing this paper, AT was an employee and shareholder of Novo Nordisk. This work was funded before AT became a Novo Nordisk employee and Novo Nordisk has no role in this project. The views expressed in this report are those of the authors and not those of Novo Nordisk. AT currently is an employee of Amgen Research Copenhagen (ARC). ARC had no role in this project or this manuscript. Emma Frew (EF) has received funding from industry and has received consulting fees from Novo Nordisk. She has received consulting fees from UK local and regional government. EF has Membership of NIHR-funded trial steering committees, was an Elected Board member for the International Health Economics Association, a Trustee for the Association for Study of Obesity, and is a member of the strategic advisory council for the APPG-obesity. No conflicts of interest were declared by other authors.","order":3,"name":"Ethics","label":"Competing Interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}