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Episode 6 - Pharmacotherapy Versus Bariatric Surgery
Substantial and sustained weight loss results in improvements in obesity-related comorbidities, and clinicians may consider pharmacotherapy and/or bariatric surgery in appropriate patients. Peter Salgo, MD, comments that bariatric surgery is a more expensive option compared with pharmacotherapy.
Although pharmacotherapy may be less expensive, Yehuda Handelsman, MD, FACP, FACE, FNLA, notes that surgery is a first-choice option for many patients, especially for patients who have a body mass index of 35 or greater and need to lose a larger proportion of weight very quickly.
Maria Lopes, MD, MS, explains that in order to evaluate the financial benefits of pharmacotherapy and bariatric surgery, comparative effectiveness data are needed. Even more important, Dr Lopes states, are data to show that pharmacotherapy options are truly effective.
Jeffrey D. Dunn, PharmD, MBA, comments that because treating obesity is expensive, key stakeholders in healthcare need to figure out how to better spend the limited resources currently available for the management of obesity.
Together, Kari Uusinarkaus, MD, FAAFP, FNLA, and Drs Handelsman and Lopes conclude that a multi-stakeholder approach, with help from the government, is necessary. Dr Handelsman adds that because obesity is so expensive, prevention programs are essential.
Managed Care Reflections: A Q&A With A. Mark Fendrick, MD, and Michael E. Chernew, PhD
December 2nd 2025To mark the 30th anniversary of The American Journal of Managed Care (AJMC), each issue in 2025 includes a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The December issue features a conversation with AJMC Co–Editors in Chief A. Mark Fendrick, MD, director of the Center for Value-Based Insurance Design and a professor at the University of Michigan in Ann Arbor; and Michael E. Chernew, PhD, the Leonard D. Schaeffer Professor of Health Care Policy and the director of the Healthcare Markets and Regulation Lab at Harvard Medical School in Boston, Massachusetts.
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