Al-Sabah Salman, ElShamy Amr, Jois Sharanya, Low Kaywei, Gras Adrien, Gulnar Ece Parali
Department of Surgery, School of Medicine, Kuwait University, Kuwait City, Kuwait.
Novo Nordisk, Kuwait City, Kuwait.
J Med Econ. 2023 Jan-Dec;26(1):1368-1376. doi: 10.1080/13696998.2023.2265721. Epub 2023 Oct 28.
44% of Kuwait's population live with obesity and the health consequences place a significant burden on the public health system. This study provides an assessment of the cost burden of obesity-related comorbidities (ORC).
A retrospective micro-costing analysis was conducted to quantify the direct cost associated with ORCs. ORCs and their cost categories were informed by a systematic literature review and validated by a local steering committee comprising three experts. Seventy public sector clinicians and eight hospital procurement staff were surveyed to provide healthcare resource utilization estimates and medical resource cost data, respectively. The annual cost of each ORC and the cost drivers were also validated by the steering committee.
Individuals in Kuwait with any single ORC incurred direct healthcare costs ranging 1,748-4,205 KWD annually. Asthma, chronic kidney disease and type 2 diabetes were the costliest ORCs, incurring an annual cost that exceeds 3,500 KWD per patient. Hypertension, angina and atrial fibrillation were the least costly ORCs. In general, costs were driven by drug costs and resources allocated to address treatment-related adverse events.
In the absence of an official patient registry in Kuwait, our study provides a conservative estimate of direct costs derived from a nationwide survey. Additionally, the cost estimates in this study assumes that a patient with obesity will only experience one ORC. In reality, multi-morbid states may incur additional costs that are not currently captured.
Our study confirms that ORCs generate a significant financial burden to the public payer. The study provides an economic case for policymakers to recognize the exigency for obesity prevention and control in accordance with the ORC prevalence, and the need for sustainable investments towards body-mass index management to prevent individuals from developing multiple comorbidities.
科威特44%的人口患有肥胖症,其健康后果给公共卫生系统带来了沉重负担。本研究对肥胖相关合并症(ORC)的成本负担进行了评估。
进行了一项回顾性微观成本分析,以量化与ORC相关的直接成本。ORC及其成本类别通过系统的文献综述确定,并由一个由三名专家组成的当地指导委员会进行验证。对70名公共部门临床医生和8名医院采购人员进行了调查,分别提供医疗资源利用估计和医疗资源成本数据。每个ORC的年度成本和成本驱动因素也由指导委员会进行了验证。
科威特患有任何单一ORC的个体每年产生的直接医疗费用在1748-4205科威特第纳尔之间。哮喘、慢性肾病和2型糖尿病是成本最高的ORC,每名患者每年的成本超过3500科威特第纳尔。高血压、心绞痛和心房颤动是成本最低的ORC。一般来说,成本由药物成本和用于处理治疗相关不良事件的资源驱动。
由于科威特没有官方的患者登记系统,我们的研究对全国范围内调查得出的直接成本提供了保守估计。此外,本研究中的成本估计假设肥胖患者只会经历一种ORC。实际上,多种合并症状态可能会产生目前未涵盖的额外成本。
我们的研究证实,ORC给公共支付者带来了巨大的经济负担。该研究为政策制定者提供了一个经济案例,以认识到根据ORC患病率预防和控制肥胖的紧迫性,以及对体重指数管理进行可持续投资以防止个体发展多种合并症的必要性。