Yilmaz Esra Safak, Malhan Simten, Gurser Batu, Gogas Yavuz Dilek
Novo Nordısk, Patient Access and Public Affairs Department, Istanbul, Istanbul, Turkey.
Baskent Unıversıty, Department of Healthcare Management, Ankara, Turkey.
Clinicoecon Outcomes Res. 2025 Apr 5;17:277-287. doi: 10.2147/CEOR.S500142. eCollection 2025.
According to the World Health Organization European Regional Obesity Report, Turkey has the highest rate of overweight and obesity in Europe. This study used a weight loss pharmacoeconomic model to assess the influence of obesity on public health by examining its effects on private health institutions and its financial costs.
A micro-costing approach was used to estimate the direct healthcare costs of 10 obesity-related comorbidities from the perspective of private healthcare providers in Turkey. A survey was conducted on a representative sample of physicians in Turkey to determine resource utilization rates for comorbidities in expenditures. The unit costs of each cost item were analyzed for type A, B, and C private hospitals. Costs in the different categories were obtained by multiplying the unit costs by the health resource utilization rate.
When the obesity-related complications were stratified according to weight loss rate, 5%, 10%, and 20%, a higher cost reduction was observed in the 40-49, 50-59, and 60-69 age groups. It should be noted that this decrease in healthcare expenditure was detected in the older age groups (40 to 69) and not in individuals between 20 and 39 years. Another analysis of the weight loss rate revealed that the decrease was highest in Type 2 Diabetes Mellitus costs. A health expenditure that costs 1 unit in a C-segment institution increases 1.44-fold in B-segment and 3-fold in A-segment hospitals. The effects of weight loss on reducing the cost of obesity-related complications indicated that the highest cost reduction was on T2DM, dyslipidemia, and CKD, respectively. Obesity-related complications constituted 28.87% of total costs in Segment A hospitals, 29.13% in Segment B hospitals, and 28.54% in Segment C hospitals.
The current pharmacoeconomic model indicated that complications were the major cost drivers in obesity. Weight loss dramatically reduced healthcare expenditures in obese patients, and T2DM was the leading cause in all age groups.
根据世界卫生组织欧洲区域肥胖报告，土耳其的超重和肥胖率在欧洲最高。本研究使用了一种减肥药物经济学模型，通过考察肥胖对私立医疗机构的影响及其财务成本，来评估肥胖对公共卫生的影响。
采用微观成本核算方法，从土耳其私立医疗服务提供者的角度估算10种与肥胖相关的合并症的直接医疗成本。对土耳其医生的代表性样本进行了一项调查，以确定合并症在支出方面的资源利用率。对A、B、C三类私立医院的每个成本项目的单位成本进行了分析。不同类别的成本通过将单位成本乘以卫生资源利用率来获得。
当根据5%、10%和20%的减肥率对与肥胖相关的并发症进行分层时，在40-49岁、50-59岁和60-69岁年龄组中观察到更高的成本降低。应当指出，这种医疗支出的减少在老年组（40至69岁）中被检测到，而在20至39岁的个体中未被检测到。对减肥率的另一项分析表明，2型糖尿病成本的下降幅度最大。在C类机构花费1个单位的医疗支出在B类医院增加1.44倍，在A类医院增加3倍。减肥对降低与肥胖相关并发症成本的影响表明，成本降低幅度最大的分别是2型糖尿病、血脂异常和慢性肾脏病。与肥胖相关的并发症在A类医院总成本中占28.87%，在B类医院占29.13%，在C类医院占28.54%。
当前的药物经济学模型表明，并发症是肥胖的主要成本驱动因素。减肥显著降低了肥胖患者的医疗支出，并且2型糖尿病在所有年龄组中都是主要原因。
