沙特阿拉伯私营医疗保险肥胖成年人减肥对肥胖相关结局的十年成本效益分析。

Ten-year cost-consequence analysis of weight loss on obesity-related outcomes in privately insured adults with obesity in Saudi Arabia.

机构信息

Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.

Health Technology Assessment Unit, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.

出版信息

J Med Econ. 2023 Jan-Dec;26(1):802-810. doi: 10.1080/13696998.2023.2221570.

DOI:10.1080/13696998.2023.2221570

PMID:37272736

Abstract

AIM

This study aimed to estimate the 10-year cost-consequence of weight loss on obesity-related outcomes in a sample of privately insured adults with obesity in Saudi Arabia (KSA).

METHODS

We analyzed data of adults with obesity (BMI ≥ 30 kg/m) available in Nphies, the private health insurance platform of the Council of Health Insurance, KSA. A micro-costing analysis was used to obtain domestic cost estimates for obesity-related outcomes. Cox proportional hazard models were used to estimate the benefit of weight loss by preventing incident cases of 10 obesity-related outcomes.

RESULTS

In the study cohort ( = 314,079), the 30-34.9 BMI category contributed two-thirds of the cohort, and no gender differences were found in the age distribution of BMI categories. The elderly population had a higher prevalence of obesity-related outcomes, such as hypertension, osteoarthritis, and type 2 diabetes mellitus (T2DM). The baseline cost (2023) for treating these outcomes was USD 1.245 billion, which could double in 10 years. A 15% weight loss could save USD 1.295 billion over 10 years, with most savings due to T2DM (USD 430 million), given its higher prevalence (27.5%). The model was most sensitive to cost variability in T2DM, dyslipidemia, and hypertension.

LIMITATIONS

The results should be interpreted within the bounds of the study cohort, and Nphies is in its early stages of implementation. The cost estimates may differ if repeated among adults with obesity only, potentially leading to increased cost savings with weight loss.

CONCLUSIONS

Moderate weight loss of 5-15% over 10 years is associated with substantial cost savings in Saudi Arabia. For a 15% weight loss, 18.8% of incidence cases of obesity-related outcomes may be prevented, and slowed increases in T2DM, dyslipidemia, and hypertension may lead to considerable cost savings. The findings would help policymakers to implement weight loss programs in KSA.

摘要

目的

本研究旨在估计在沙特阿拉伯（KSA）的私人保险肥胖成年人样本中，减肥对肥胖相关结局的 10 年成本效益。

方法

我们分析了 Nphies 中肥胖成年人（BMI≥30kg/m）的数据，Nphies 是 KSA 健康保险委员会的私人医疗保险平台。使用微观成本分析来获得肥胖相关结局的国内成本估算。使用 Cox 比例风险模型来估计通过预防 10 种肥胖相关结局的新发病例来减轻体重的益处。

结果

在研究队列（n=314079）中，30-34.9 BMI 类别占队列的三分之二，且 BMI 类别在性别分布上没有差异。老年人口中肥胖相关结局（如高血压、骨关节炎和 2 型糖尿病（T2DM））的患病率较高。治疗这些结局的基线成本（2023 年）为 12.45 亿美元，10 年内可能翻一番。10 年内体重减轻 15%可节省 12.95 亿美元，其中大部分节省归因于 T2DM（4.3 亿美元），因为其患病率较高（27.5%）。该模型对 T2DM、血脂异常和高血压的成本变异性最敏感。