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Published in: BMC Health Services Research 1/2013

Open Access 01-12-2013 | Research article

Impact of BMI and BMI change on future drug expenditures in adults: results from the MONICA/KORA cohort study

Authors: Christina M Teuner, Petra Menn, Margit Heier, Rolf Holle, Jürgen John, Silke B Wolfenstetter

Published in: BMC Health Services Research | Issue 1/2013

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Abstract

Background

The evidence on the long-term economic effects of obesity is still scarce. This study aims to analyse the impact of body mass index (BMI) and BMI-change on future pharmaceutical utilisation and expenditures.

Methods

Based on data from 2,946 participants in a German population-based health survey (MONICA/KORA, 1994/95) and the follow-up study (2004/05), drug intake and expenditures were estimated using a bottom-up approach. Using univariate and multivariate methods, we analysed the impact of baseline BMI and BMI-change on drug utilisation and expenditures after 10 years.

Results

The use of pharmaceuticals was more likely in moderately and severely obese compared to the normal weight group (OR 1.8 and 4.0, respectively). In those who reported pharmaceutical intake, expenditures were about 40% higher for the obese groups. A 1-point BMI-gain in 10 years was, on average, associated with almost 6% higher expenditures compared to a constant BMI.

Conclusion

The results suggest that obesity as well as BMI-gain are strong predictors of future drug utilisation and associated expenditures in adults, and thus highlight the necessity of timely and effective intervention and prevention programmes. This study complements the existing literature and provides important information on the relevance of obesity as a health problem.
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Literature
2.
go back to reference Mensink GB, Lampert T, Bergmann E: [Overweight and obesity in Germany 1984–2003]. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz. 2005, 48 (12): 1348-1356.CrossRef Mensink GB, Lampert T, Bergmann E: [Overweight and obesity in Germany 1984–2003]. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz. 2005, 48 (12): 1348-1356.CrossRef
3.
4.
go back to reference Cawley J, Spiess CK: Obesity and skill attainment in early childhood. Econ Hum Biol. 2008, 6 (3): 388-397.CrossRefPubMed Cawley J, Spiess CK: Obesity and skill attainment in early childhood. Econ Hum Biol. 2008, 6 (3): 388-397.CrossRefPubMed
5.
go back to reference Finkelstein EA, Ruhm CJ, Kosa KM: Economic causes and consequences of obesity. Annu Rev Public Health. 2005, 26: 239-257.CrossRefPubMed Finkelstein EA, Ruhm CJ, Kosa KM: Economic causes and consequences of obesity. Annu Rev Public Health. 2005, 26: 239-257.CrossRefPubMed
6.
go back to reference Breitfelder A, Wenig CM, Wolfenstetter SB, Rzehak P, Menn P, John J, Leidl R, Bauer CP, Koletzko S, Röder S, et al: Relative Weight Related Direct Costs of Healthcare Use by Children – Empirical analysis based on two German Birth Cohorts (GINI-plus, LISA-plus). Econ Hum Biol. 2011, 9 (3): 302-315.CrossRefPubMed Breitfelder A, Wenig CM, Wolfenstetter SB, Rzehak P, Menn P, John J, Leidl R, Bauer CP, Koletzko S, Röder S, et al: Relative Weight Related Direct Costs of Healthcare Use by Children – Empirical analysis based on two German Birth Cohorts (GINI-plus, LISA-plus). Econ Hum Biol. 2011, 9 (3): 302-315.CrossRefPubMed
7.
go back to reference Wenig CM: The impact of BMI on direct costs in Children and Adolescents - Empirical findings for the German Healthcare System based on the KiGGS-study. Eur J Health Econ. 2010, Sep 29. [Epub ahead of print] Wenig CM: The impact of BMI on direct costs in Children and Adolescents - Empirical findings for the German Healthcare System based on the KiGGS-study. Eur J Health Econ. 2010, Sep 29. [Epub ahead of print]
8.
go back to reference John J, Wenig CM, Wolfenstetter SB: Recent economic findings on childhood obesity: cost-of-illness and cost-effectiveness of interventions. Curr Opin Clin Nutri Metab Care. 2010, 13 (3): 305-313.CrossRef John J, Wenig CM, Wolfenstetter SB: Recent economic findings on childhood obesity: cost-of-illness and cost-effectiveness of interventions. Curr Opin Clin Nutri Metab Care. 2010, 13 (3): 305-313.CrossRef
9.
go back to reference Stuart B, Lloyd J, Zhao L, Kamal-Bahl S: Obesity, disease burden, and prescription spending by community-dwelling Medicare beneficiaries. Curr Med Res Opin. 2008, 24 (8): 2377-2387.CrossRefPubMed Stuart B, Lloyd J, Zhao L, Kamal-Bahl S: Obesity, disease burden, and prescription spending by community-dwelling Medicare beneficiaries. Curr Med Res Opin. 2008, 24 (8): 2377-2387.CrossRefPubMed
10.
go back to reference Finkelstein EA, Trogdon JG, Cohen JW, Dietz W: Annual medical spending attributable to obesity: payer-and service-specific estimates. Health Affairs (Millwood). 2009, 28 (5): w822-831.CrossRef Finkelstein EA, Trogdon JG, Cohen JW, Dietz W: Annual medical spending attributable to obesity: payer-and service-specific estimates. Health Affairs (Millwood). 2009, 28 (5): w822-831.CrossRef
11.
go back to reference Arterburn DE, Maciejewski ML, Tsevat J: Impact of morbid obesity on medical expenditures in adults. Int J Obesity (Lond). 2005, 29 (3): 334-339.CrossRef Arterburn DE, Maciejewski ML, Tsevat J: Impact of morbid obesity on medical expenditures in adults. Int J Obesity (Lond). 2005, 29 (3): 334-339.CrossRef
12.
go back to reference Counterweight Project Team: Influence of body mass index on prescribing costs and potential cost savings of a weight management programme in primary care. J health serv res policy. 2008, 13 (3): 158-166.CrossRef Counterweight Project Team: Influence of body mass index on prescribing costs and potential cost savings of a weight management programme in primary care. J health serv res policy. 2008, 13 (3): 158-166.CrossRef
13.
go back to reference von Lengerke T, Reitmeir P, John J: Direct medical costs of (severe) obesity: a bottom-up assessment of over- vs. normal-weight adults in the KORA-study region (Augsburg, Germany) [in German]. Gesundheitswesen. 2006, 68 (2): 110-115.CrossRefPubMed von Lengerke T, Reitmeir P, John J: Direct medical costs of (severe) obesity: a bottom-up assessment of over- vs. normal-weight adults in the KORA-study region (Augsburg, Germany) [in German]. Gesundheitswesen. 2006, 68 (2): 110-115.CrossRefPubMed
14.
go back to reference Prugger C, Keil U: Development of obesity in Germany - prevalence, determinants and perspectives [in German]. Dtsch Med Wochenschr. 2007, 132 (16): 892-897.CrossRefPubMed Prugger C, Keil U: Development of obesity in Germany - prevalence, determinants and perspectives [in German]. Dtsch Med Wochenschr. 2007, 132 (16): 892-897.CrossRefPubMed
15.
go back to reference Janssen I, Katzmarzyk PT, Srinivasan SR, Chen W, Malina RM, Bouchard C, Berenson GS: Utility of childhood BMI in the prediction of adulthood disease: comparison of national and international references. Obes Res. 2005, 13 (6): 1106-1115.CrossRefPubMed Janssen I, Katzmarzyk PT, Srinivasan SR, Chen W, Malina RM, Bouchard C, Berenson GS: Utility of childhood BMI in the prediction of adulthood disease: comparison of national and international references. Obes Res. 2005, 13 (6): 1106-1115.CrossRefPubMed
16.
go back to reference Højgaard B, Olsen KR, Søgaard J, Sørensen TIA, Gyrd-Hansen D: Economic costs of abdominal obesity. Obes Facts. 2008, 1: 146-154.CrossRefPubMed Højgaard B, Olsen KR, Søgaard J, Sørensen TIA, Gyrd-Hansen D: Economic costs of abdominal obesity. Obes Facts. 2008, 1: 146-154.CrossRefPubMed
17.
go back to reference Hojgaard B, Gyrd-Hansen D, Olsen KR, Sogaard J, Sorensen TI: Waist circumference and body mass index as predictors of health care costs. PLoS One. 2008, 3 (7): e2619.CrossRefPubMedPubMedCentral Hojgaard B, Gyrd-Hansen D, Olsen KR, Sogaard J, Sorensen TI: Waist circumference and body mass index as predictors of health care costs. PLoS One. 2008, 3 (7): e2619.CrossRefPubMedPubMedCentral
18.
go back to reference Dilla T, Valladares A, Nicolay C, Salvador J, Reviriego J, Costi M: Healthcare Costs Associated with Change in Body Mass Index in Patients with Type 2 Diabetes Mellitus in Spain: The ECOBIM Study. App health econ health policy. 2012, 10 (6): 417-430.CrossRef Dilla T, Valladares A, Nicolay C, Salvador J, Reviriego J, Costi M: Healthcare Costs Associated with Change in Body Mass Index in Patients with Type 2 Diabetes Mellitus in Spain: The ECOBIM Study. App health econ health policy. 2012, 10 (6): 417-430.CrossRef
19.
go back to reference Thompson D, Brown JB, Nichols GA, Elmer PJ, Oster G: Body mass index and future healthcare costs: a retrospective cohort study. Obes Res. 2001, 9 (3): 210-218.CrossRefPubMed Thompson D, Brown JB, Nichols GA, Elmer PJ, Oster G: Body mass index and future healthcare costs: a retrospective cohort study. Obes Res. 2001, 9 (3): 210-218.CrossRefPubMed
20.
go back to reference Wolfenstetter SB: Future direct and indirect costs of obesity and the influence of gaining weight: results from the MONICA/KORA cohort studies, 1995–2005. Econ Hum Biol. 2012, 10 (2): 127-138.CrossRefPubMed Wolfenstetter SB: Future direct and indirect costs of obesity and the influence of gaining weight: results from the MONICA/KORA cohort studies, 1995–2005. Econ Hum Biol. 2012, 10 (2): 127-138.CrossRefPubMed
21.
go back to reference Wolfenstetter SB, Menn P, Holle R, Mielck A, Meisinger C, von Lengerke T: Body weight changes and outpatient medical care utilisation: Results of the MONICA/KORA cohorts S3/F3 and S4/F4. Psycho-social med. 2012, 9: Doc09. Wolfenstetter SB, Menn P, Holle R, Mielck A, Meisinger C, von Lengerke T: Body weight changes and outpatient medical care utilisation: Results of the MONICA/KORA cohorts S3/F3 and S4/F4. Psycho-social med. 2012, 9: Doc09.
22.
go back to reference World Health Organization WHO: Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000, 894 (i-xii): 1-253. World Health Organization WHO: Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000, 894 (i-xii): 1-253.
23.
go back to reference Holle R, Happich M, Lowel H, Wichmann HE: KORA - a research platform for population based health research. Gesundheitswesen. 2005, 67 (Suppl 1): S19-25.CrossRefPubMed Holle R, Happich M, Lowel H, Wichmann HE: KORA - a research platform for population based health research. Gesundheitswesen. 2005, 67 (Suppl 1): S19-25.CrossRefPubMed
24.
go back to reference Helmert U, Shea S: Social inequalities and health status in western Germany. Pub Health. 1994, 108 (5): 341-356.CrossRef Helmert U, Shea S: Social inequalities and health status in western Germany. Pub Health. 1994, 108 (5): 341-356.CrossRef
25.
go back to reference Helmert U, Mielck A, Shea S: Poverty and health in West Germany. Soz Praventivmed. 1997, 42 (5): 276-285.CrossRefPubMed Helmert U, Mielck A, Shea S: Poverty and health in West Germany. Soz Praventivmed. 1997, 42 (5): 276-285.CrossRefPubMed
26.
go back to reference Helmert U, Strube H: The development of obesity in Germany in the period from 1985 until 2000 [in German]. Gesundheitswesen. 2004, 66 (7): 409-415.CrossRefPubMed Helmert U, Strube H: The development of obesity in Germany in the period from 1985 until 2000 [in German]. Gesundheitswesen. 2004, 66 (7): 409-415.CrossRefPubMed
27.
go back to reference Jöckel K-H, Babitsch B, Bellach B-M, Bloomfield K, Hoffmeyer-Zlontnik J, Winkler J, Wolf C: Empfehlungen der deutschen Arbeitsgruppe “Epidemiologische Methoden” in der Deutschen Arbeitsgemeischaft Epidemiologie der Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (GMDS) und der Deutschen Gesellschaft für Sozialmedizin und Prävention (DGSMP) zur Messung und Quantifizierung soziodemographischer Merkmale in epidemiologischen Studien [in German]. Messung soziodemographischer Merkmale in der Epidemiologie (RKI-Schriften 1/98). Edited by: Ahrens W, Bellach B-M, Jöckel K-H. 1998, Munich: MMV-Verlag, 7-38. Jöckel K-H, Babitsch B, Bellach B-M, Bloomfield K, Hoffmeyer-Zlontnik J, Winkler J, Wolf C: Empfehlungen der deutschen Arbeitsgruppe “Epidemiologische Methoden” in der Deutschen Arbeitsgemeischaft Epidemiologie der Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (GMDS) und der Deutschen Gesellschaft für Sozialmedizin und Prävention (DGSMP) zur Messung und Quantifizierung soziodemographischer Merkmale in epidemiologischen Studien [in German]. Messung soziodemographischer Merkmale in der Epidemiologie (RKI-Schriften 1/98). Edited by: Ahrens W, Bellach B-M, Jöckel K-H. 1998, Munich: MMV-Verlag, 7-38.
28.
go back to reference Mielck A: Soziale Ungleichheit und Gesundheit [in German]. 2000, Bern: Hans Huber Mielck A: Soziale Ungleichheit und Gesundheit [in German]. 2000, Bern: Hans Huber
29.
go back to reference Mühlberger N, Behrend C, Stark R, Holle R: Database-supported identification and entry of drug data in health studies - experience with the IDOM software [in German]. Informatik, Biometrie und Epidemiologie in Medizin und Biologie. 2003, 34 (4): 601-611. Mühlberger N, Behrend C, Stark R, Holle R: Database-supported identification and entry of drug data in health studies - experience with the IDOM software [in German]. Informatik, Biometrie und Epidemiologie in Medizin und Biologie. 2003, 34 (4): 601-611.
30.
go back to reference Krauth C, Hessel F, Hansmeier T, Wasem J, Seitz R, Schweikert B: Empirische Bewertungssätze in der gesundheitsökonomischen Evaluation - ein Vorschlag der AG Methoden der gesundheitsökonomischen Evaluation (AG MEG). Gesundheitswesen. 2005, 67 (10): 736-746.CrossRefPubMed Krauth C, Hessel F, Hansmeier T, Wasem J, Seitz R, Schweikert B: Empirische Bewertungssätze in der gesundheitsökonomischen Evaluation - ein Vorschlag der AG Methoden der gesundheitsökonomischen Evaluation (AG MEG). Gesundheitswesen. 2005, 67 (10): 736-746.CrossRefPubMed
31.
go back to reference Braun S, Prenzler A, Mittendorf T, von der Schulenburg JM: Appraisal of resource use in the German health-care system from the perspective of the statutory health insurance [in German]. Gesundheitswesen. 2009, 71 (1): 19-23.CrossRefPubMed Braun S, Prenzler A, Mittendorf T, von der Schulenburg JM: Appraisal of resource use in the German health-care system from the perspective of the statutory health insurance [in German]. Gesundheitswesen. 2009, 71 (1): 19-23.CrossRefPubMed
32.
go back to reference Duan N, Manning W, Morris C, Newhouse J: A Comparison of Alternative Models for the Demand for Medical Care. J Business Econ Stat. 1983, 1 (2): 115-126. Duan N, Manning W, Morris C, Newhouse J: A Comparison of Alternative Models for the Demand for Medical Care. J Business Econ Stat. 1983, 1 (2): 115-126.
33.
go back to reference Kilian R, Matschinger H, Loeffler W, Roick C, Angermeyer MC: A comparison of methods to handle skew distributed cost variables in the analysis of the resource consumption in schizophrenia treatment. J Ment Health Policy. 2002, 5 (1): 21-31. Kilian R, Matschinger H, Loeffler W, Roick C, Angermeyer MC: A comparison of methods to handle skew distributed cost variables in the analysis of the resource consumption in schizophrenia treatment. J Ment Health Policy. 2002, 5 (1): 21-31.
34.
go back to reference Manning WG, Basu A, Mullahy J: Generalized modeling approaches to risk adjustment of skewed outcomes data. J Health Econ. 2005, 24 (3): 465-488.CrossRefPubMed Manning WG, Basu A, Mullahy J: Generalized modeling approaches to risk adjustment of skewed outcomes data. J Health Econ. 2005, 24 (3): 465-488.CrossRefPubMed
35.
36.
go back to reference Andersen RM: Revisiting the behavioral model and access to medical care: does it matter?. J Health Soc Behav. 1995, 36 (1): 1-10.CrossRefPubMed Andersen RM: Revisiting the behavioral model and access to medical care: does it matter?. J Health Soc Behav. 1995, 36 (1): 1-10.CrossRefPubMed
37.
go back to reference Smith TG, Stoddard C, Barnes MG: Why the Poor Get Fat: Weight Gain and Economic Insecurity. Forum Health Econ Policy. 2009, 12 (2): 5.CrossRef Smith TG, Stoddard C, Barnes MG: Why the Poor Get Fat: Weight Gain and Economic Insecurity. Forum Health Econ Policy. 2009, 12 (2): 5.CrossRef
38.
go back to reference Sobal J, Stunkard AJ: Socioeconomic status and obesity: a review of the literature. Psychol Bull. 1989, 105 (2): 260-275.CrossRefPubMed Sobal J, Stunkard AJ: Socioeconomic status and obesity: a review of the literature. Psychol Bull. 1989, 105 (2): 260-275.CrossRefPubMed
39.
go back to reference Akobundu E, Ju J, Blatt L, Mullins CD: Cost-of-illness studies: a review of current methods. Pharmacoeconomics. 2006, 24 (9): 869-890.CrossRefPubMed Akobundu E, Ju J, Blatt L, Mullins CD: Cost-of-illness studies: a review of current methods. Pharmacoeconomics. 2006, 24 (9): 869-890.CrossRefPubMed
Metadata
Title
Impact of BMI and BMI change on future drug expenditures in adults: results from the MONICA/KORA cohort study
Authors
Christina M Teuner
Petra Menn
Margit Heier
Rolf Holle
Jürgen John
Silke B Wolfenstetter
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2013
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-13-424

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