Abstract
This study estimated the economic burden of illness of obesity and selected comorbidities in terms of health outcome and costs to society and healthcare payer in Germany. The proportions of selected diseases (comorbidities) attributable solely to obesity were estimated using odds ratios/relative risks and prevalences based on data from the literature. The top-down approach was employed to match healthcare spending with the number of patients suffering from obesity (BMI 30+) and the major comorbidities to evaluate overall direct and indirect costs. In Germany there are approximately 12.24 million obese adults, 2.06–3.76 million of whom suffer from the selected comorbidities. From a societal perspective the total costs for obesity and comorbidities are €2,701–5,682 million per year and the direct treatment costs alone account for €1,343–2,699 million, imposing a major burden to the healthcare system. In view of the magnitude of the economic burden of illness there is a need for both further research and action at the health policy level.
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Acknowledgements
We thank Anja Hommel, MSc, and Jens P. Diedrich, PhD, for their contribution to a former version of the manuscript. We are also grateful to Elvira Müller, PhD, for her intellectual contribution and critical reading of the manuscript.
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Financial support for this study was provided entirely by a contract with Abbott GmbH & Co KG, Center for Pharmaceutical Appraisal & Outcomes Research. The funding agreement ensured the authors' independence in designing the study, interpreting the data, writing, and publishing the report.
Appendix: calculation of exposure-dependent prevalence
Appendix: calculation of exposure-dependent prevalence
Given:
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T fields N, e, f, g, h in Table 5
-
Odds ratio (OR)
Only one of the fields a, b, c, or d needs to be calculated to estimate all the others:
Equation 1 needs to be substituted to estimate a:
Substitution of Eq. 1 with Eqs. 2, 3, and 4 leads to:
Rearranging:
→ quadratic equation: x 2+px+q=0 where:
→ solution to quadratic equation: \( x = - {\textstyle{p \over 2}} \pm \sqrt {{\textstyle{{p^2 } \over 4}} - q} \)→ substitute with Eqs. 5, 6, and 7:
The attributable proportion in the population (AP pop ) is then calculated by:
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Sander, B., Bergemann, R. Economic burden of obesity and its complications in Germany. HEPAC 4, 248–253 (2003). https://doi.org/10.1007/s10198-003-0178-1
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DOI: https://doi.org/10.1007/s10198-003-0178-1