Gogas Yavuz Dilek, Akhtar Omar, Low Kaywei, Gras Adrien, Gurser Batu, Yilmaz Esra Safak, Basse Amaury
School of Medicine, Marmara University, Section of Endocrinology and Metabolism, Istanbul, Turkey.
Healthcare Market Access, Ipsos, Singapore.
Clinicoecon Outcomes Res. 2024 Mar 5;16:123-132. doi: 10.2147/CEOR.S446560. eCollection 2024.
Turkey currently has the highest obesity prevalence among its European counterparts. 32% and 61% of the population live with obesity and overweight, respectively. Overweight and obesity are linked to non-communicable diseases that incur incremental health and economic costs. The significant public health concern warrants an assessment of the cost of obesity.
A micro-costing approach from the public payer perspective was conducted to estimate direct healthcare costs associated with ten obesity-related comorbidities (ORCs) in Turkey. Clinical practice guidelines and a systematic literature review informed ORCs and the respective cost categories. This was subsequently validated by a steering committee comprising seven experts. Seventy public sector physicians were surveyed to estimate healthcare resource use. Unit costs were derived from Social Security Institute's Healthcare Implementation Communique. Cost items were summed to determine the annual cost per patient per ORC, which was validated by the steering committee. Medical inflation was considered in a scenario analysis that varied resource unit costs.
Chronic kidney disease, heart failure and type 2 diabetes are the costliest ORCs, incurring an annual cost of 28,600 TRY, 16,639 TRY and 11,993 TRY, respectively. Individuals in Turkey with any ORC triggered direct healthcare costs ranging 1857-28,600 TRY annually. Costs were driven by tertiary care resources arising from treatment-related adverse events, disease complications and inpatient procedures. In the scenario analysis, medical resource unit costs were inflated by 18.7% and 39.4%, triggering an average increase in cost across all ORCs of 1998 TRY and 4210 TRY, respectively.
Our findings confirm that obesity and its complications result in significant financial burden to the public healthcare system. By quantifying the burden of obesity across a comprehensive spectrum of ORCs, our study aims to support the economic case for investing in appropriate obesity interventions.
土耳其目前在欧洲国家中肥胖患病率最高。分别有32%和61%的人口患有肥胖症和超重。超重和肥胖与非传染性疾病相关，会带来不断增加的健康和经济成本。这一重大的公共卫生问题需要对肥胖成本进行评估。
从公共支付方的角度采用微观成本核算方法，来估算土耳其与十种肥胖相关合并症（ORC）相关的直接医疗成本。临床实践指南和系统的文献综述为ORC及相应成本类别提供了依据。随后由一个由七名专家组成的指导委员会进行了验证。对70名公共部门医生进行了调查，以估算医疗资源的使用情况。单位成本来自社会保障局的医疗实施公报。将各项成本相加，以确定每种ORC每位患者的年度成本，该成本经指导委员会验证。在情景分析中考虑了医疗通胀，该分析改变了资源单位成本。
慢性肾病、心力衰竭和2型糖尿病是成本最高的ORC，每年的成本分别为28,600土耳其里拉、16,639土耳其里拉和11,993土耳其里拉。土耳其患有任何一种ORC的个体每年引发的直接医疗成本在1857 - 28,600土耳其里拉之间。成本由与治疗相关的不良事件、疾病并发症和住院手术产生的三级医疗资源驱动。在情景分析中，医疗资源单位成本分别上涨了18.7%和39.4%，导致所有ORC的成本平均分别增加了1998土耳其里拉和4210土耳其里拉。
我们的研究结果证实，肥胖及其并发症给公共医疗系统带来了巨大的经济负担。通过全面量化各种ORC的肥胖负担，我们的研究旨在支持为适当的肥胖干预措施投资的经济理由。
