The Swedish cost burden of overweight and obesity – evaluated with the PAR approach and a statistical modelling approach

Abstract

The rising trend in the prevalence of obesity, which is a major risk factor for a number of diseases notably diabetes and cardiovascular diseases, has become a major public health concern in many countries during the past decades. This development has also led to an increased cost burden on the public health care delivery system that has been documented in many studies. The standard approach taken for estimating the cost burden attributed to a risk factor is the so-called PAR (Population Attributed Risk) approach; an approach that is based on cross-sectional data. In this paper, the methods and findings of two studies that have documented the cost burden attributed to overweight and obesity on the public health care delivery system in Sweden are contrasted: one using the PAR approach and one using a statistical modeling approach based on longitudinal hospital care data for 15 years for 33 000 individuals. The main motivation for this paper is that the study using the PAR approach is only available in the Swedish language. The PAR approach estimated a cost burden of 3 600 million SEK (390 million Euro), equavalent to 1.9% of national health care expenditure, out of which 1 800 million SEK (190 million Euro) were spent on hospital care. The statistical modeling approach estimated the corresponding cost burden for hospital care at 2 100 million SEK (230 million Euro). The statistical modeling approach presents no estimates of the total cost burden attributed to overweight and obesity.

Health burden and costs of obesity and overweight in Germany

“…Like many cost of illness studies of obesity and overweight, we used a prevalence-based approach [35,36,38,42]. By using this approach, one implicitly assumes that the risk factor and the resulting disease occur within the same period, which is mostly not the case in reality.…”

“…However, we determined direct costs corresponding to about 2.1% of total health care expenditures, whereas international studies on the costs of obesity found direct costs of between 1.9 and 7.8% of health care costs [34][35][36][37][38][39][40][41][42][43].…”

A case study of ex ante, value-based price and reimbursement decision-making: TLV and rimonabant in Sweden

“…Even within indications the cost-effectiveness will differ across patients because of differences in baseline risk and relative effect [6][7][8]. Whenever relevant, and this is typically the case, formal cost-effectiveness data are required and an important part of the decision-making process.…”

A review of the efficacy and safety of the finished fixed-ratio combination of insulin degludec and liraglutide in the treatment of type 2 diabetes mellitus

“…Увеличение веса также повышает риск сердечно-сосудистых ослож-ЭНДОКРИНОЛОГИЯ нений, смерти, требует интенсификации терапии, допол-нительных затрат здравоохранения и снижает качество жизни [9,24].…”