HealthEcon AG, Basel, Switzerland.
School of Health Professions, Bern University of Applied Sciences (BFH), Bern, Switzerland.
Front Public Health. 2024 Jul 12;12:1335115. doi: 10.3389/fpubh.2024.1335115. eCollection 2024.
The prevalence of obesity has increased significantly in recent decades. Today, it is estimated that more than one-third of the world's population has overweight or obesity, rendering it one of the most significant global health concerns. This article provides a current estimate of the direct costs associated with managing overweight and obesity, including treatment of related complications, among adolescents (≥15 years) and adults in Switzerland.
Prevalence of overweight and obesity based on the BMI reported in the 2017 Swiss Health Survey was extrapolated to 2021. Systematic literature searches were performed to identify treatment costs and epidemiological data of obesity-related complications and costs were extrapolated to 2021. Costing methodology was based on available source data for individual related complications. Treatment costs for complications attributable to overweight and obesity were estimated by applying their population attributable fraction (PAF).
More than 3.1 million inhabitants of Switzerland aged ≥15 years met the criteria for overweight or obesity in 2021. The prevalence of overweight increase over the past decades from 30.4% in 1992 to 41.9% in 2017 while prevalence of obesity doubled from 5.4 to 11.3%. Overall, the total attributable costs of overweight and obesity caused by seven assessed obesity-related complications (asthma, coronary heart disease, depression, diabetes mellitus, hypertension, osteoarthritis, and stroke) are estimated at CHF 3657-5208 million with most of the costs (97-98%) caused by the assessed obesity-related complications. Only 2-3% of the total costs were attributable to the combined direct management of overweight and obesity by bariatric surgery (CHF 83 million), pharmacological therapy (CHF 26 million) and dietary counseling (CHF 18 million).
Overweight and obesity impose a significant cost impact on the Swiss healthcare system, accounting for 4.2-6.1% of total healthcare expenditures in 2021. Notably, direct treatment of overweight and obesity accounts for only 0.08-0.18% of the total healthcare expenditures. The analysis also revealed a significant lack of available health economic evidence, necessitating the use of assumptions and approximations in this estimation. This is noteworthy, as respective data would be available in healthcare systems but are either unpublished or inaccessible.
肥胖症的患病率在近几十年来显著增加。如今，据估计，世界上超过三分之一的人口超重或肥胖，这使其成为全球最重要的健康问题之一。本文提供了瑞士青少年（≥15 岁）和成年人超重和肥胖相关直接管理成本的最新估计，包括治疗相关并发症的费用。
根据 2017 年瑞士健康调查中报告的 BMI，推断出 2021 年超重和肥胖的患病率。系统地进行了文献检索，以确定肥胖相关并发症的治疗费用和流行病学数据，并将其推断至 2021 年。成本估算方法基于个体相关并发症的现有来源数据。将归因于超重和肥胖的并发症的治疗成本，通过应用其人群归因分数（PAF）进行估算。
2021 年，瑞士有超过 310 万≥15 岁的居民符合超重或肥胖标准。超重的患病率在过去几十年中有所增加，从 1992 年的 30.4%增加到 2017 年的 41.9%，而肥胖的患病率则增加了一倍，从 5.4%增加到 11.3%。总体而言，由七种评估的肥胖相关并发症（哮喘、冠心病、抑郁症、糖尿病、高血压、骨关节炎和中风）引起的超重和肥胖的总归因成本估计为 36.57 亿至 52.08 亿瑞士法郎，其中 97-98%的成本归因于评估的肥胖相关并发症。只有 2-3%的总成本归因于减肥手术（瑞士法郎 8300 万）、药物治疗（瑞士法郎 2600 万）和饮食咨询（瑞士法郎 1800 万）联合对超重和肥胖的直接管理。
超重和肥胖对瑞士医疗保健系统造成了重大的成本影响，占 2021 年总医疗保健支出的 4.2-6.1%。值得注意的是，对超重和肥胖的直接治疗仅占总医疗保健支出的 0.08-0.18%。分析还显示，在这一估算中，健康经济学方面的证据严重缺乏，因此需要使用假设和近似值。这一点值得注意，因为各自的数据在医疗保健系统中是可用的，但要么未公布，要么无法获取。
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