Healthcare costs can be around two thirds higher for obese individuals, according to a study by Lane, Clark & Peacock (LCP).
The healthcare analytics firm has published a series of real-world evidence (RWE) studies in the journal Diabetes, Obesity and Metabolism exploring how healthcare costs increase with higher BMI and obesity levels, especially when specific obesity-related complications (ORCs) are present.
It also highlighted the economic impact of obesity and the variation in costs across people living with obesity.
Costs increase
The first study, based on a UK real world dataset – Discover, included more than 1.4 million people with overweight or obesity and found that healthcare costs increased for people living with obesity by approximately 35% from 2015 to 2019.
Costs also increased with higher BMI; for example, costs were 64% higher in those with higher obesity (BMI >40 kg/m2) at £1,871 per person per year (PPPY) in 2019 compared to those who are classed as overweight (BMI ≥25-30 kg/m2) at £1,143.
While primary care appointments were the most common healthcare resource usage, inpatient admissions accounted for the largest share of costs, followed by prescriptions.
Impact of multiple ORCs
A second study assessed the presence of multiple-ORCs – ‘ORC multimorbidity’ and how this affected healthcare costs.
There are many ORCs that people with obesity are more likely to develop, such as heart disease, stroke, liver disease, type 2 diabetes, and osteoarthritis.
ORC multimorbidity was more common with higher BMI, as nearly one in three people living with obesity class III (BMI ≥40 kg/m2) had two or more ORCs compared to one in four of those in the overweight category.
Certain high-cost ORCs, such as heart failure and obstructive sleep apnoea, were three to five times more common in the highest obesity class.
Healthcare costs increased over time, with the largest increases observed in those with higher BMI/obesity class and those with ORCs.
Costs strongly skewed
But the findings also showed costs in obesity were strongly skewed, with 20% of people living with obesity accounting for 72% of all costs, with the average cost per person per year at £4,670 for the highest cost quintile.
This group tended to have higher rates of ORCs, for example, type 2 diabetes and depression being nearly five times as common compared to the lowest cost quintile.
Healthcare costs varied substantially according to the presence of ORCs.
Those with obesity incurring the highest annual costs also had heart failure (£3651–£4320 PPPY across BMI groups), chronic kidney disease (£2943–£4161), cardiovascular disease (£2685–£3492) and atrial fibrillation (£2474–£3124).
ORCs were found to increase substantially over time, with depression doubling and chronic kidney disease increasing by as much as four times over 10 years of follow-up.
Those living with obesity and three or more ORCs had approximately double the healthcare costs of those living with just one or more ORCs.
Preventing progression
Dr Jonathan Pearson-Stuttard, lead author of the studies and head of LCP’s health analytics team, said: “Our studies highlight that healthcare costs increase with BMI and are greatest in those living with more severe obesity and those living with common comorbidities such as heart disease, type 2 diabetes and depression.
“Effective action to control the risk for those living with obesity through holistic weight management as well as prevent obesity onset, prevent progression to more severe obesity and prevent the onset of obesity-related complications could have substantive benefits to patients, healthcare systems and the wider economy.”
Sara Holloway, author and senior consultant at LCP, added: “Real world datasets such as that used in this study shed light on the unequal impact of living with obesity on healthcare usage and presence of obesity-related complications.
“This can provide more timely and granular insights to enable more effective preventive and treatment measures to treat people living with obesity and other chronic conditions.”