Endoscopic sleeve gastroplasty vs lifestyle modification for weight loss: A real-world cost-effectiveness study

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Publication Name

World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Gastrointest Surg. Oct 27, 2025; 17(10): 111290
Published online Oct 27, 2025. doi: 10.4240/wjgs.v17.i10.111290

Table 3 Key scenario analysis results

	Costs (dollars)	Life years	QALYs	ICER (dollars/QALY)
Base-case results
ESG	34579	4.786	3.662
LM alone	32619	4.778	3.330
Incremental (ESG vs LM)	1960	0.007	0.332	5904
Scenario 1: 10-year time horizon
ESG	57324	8.855	6.763
LM	61766	8.811	6.149
Incremental (ESG vs LM)	-4442	0.044	0.614	ESG dominant¹
Scenario 2: Lifetime time horizon²
ESG	126638	21.401	16.351
LM	143558	20.245	14.153
Incremental (ESG vs LM)	-16920	1.156	2.198	ESG dominant¹
Scenario 3: 6% discounting rate
ESG	33723	4.618	3.533
LM	31334	4.611	3.214
Incremental (ESG vs LM)	2389	0.007	0.318	7502
Scenario 4: 0% discounting rate
ESG	35521	4.970	3.805
LM	34028	4.962	3.458
Incremental (ESG vs LM)	1493	0.008	0.347	4.304

¹Endoscopic sleeve gastroplasty results in both cost savings and higher quality-adjusted life years compared with lifestyle modification alone.

²The duration of the lifetime horizon was 54 years, based on 100 years minus the mean age at baseline (46 years).

ESG: Endoscopic sleeve gastroplasty; ICER: Incremental cost-effectiveness ratio; LM: Lifestyle modification; QALY: Quality-adjusted life year.

Citation: Donnangelo L, Gadi SRV, Maselli D, Oneill F, Wooley C, Casey S, McGowan CE. Endoscopic sleeve gastroplasty vs lifestyle modification for weight loss: A real-world cost-effectiveness study. World J Gastrointest Surg 2025; 17(10): 111290
URL: https://www.wjgnet.com/1948-9366/full/v17/i10/111290.htm
DOI: https://dx.doi.org/10.4240/wjgs.v17.i10.111290

Donnangelo L, Gadi SRV, Maselli D, Oneill F, Wooley C, Casey S, McGowan CE. Endoscopic sleeve gastroplasty vs lifestyle modification for weight loss: A real-world cost-effectiveness study. World J Gastrointest Surg 2025; 17(10): 111290 [PMID: 41178873 DOI: 10.4240/wjgs.v17.i10.111290]

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