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Do Statins Reduce the Health and Health Care Costs of Obesity?

ABSTRACT: CONTEXT:Obesity impacts both individual health and, given its high prevalence, total health care spending. However, as medical technology evolves, health outcomes for a number of obesity-related illnesses improve. This article examines whether medical innovation can mitigate the adverse health and spending associated with obesity, using statins as a case study. Because of the relationship between obesity and hypercholesterolaemia, statins play an important role in the medical management of obese individuals and the prevention of costly obesity-related sequelae. METHODS:Using well-recognized estimates of the health impact of statins and the Future Elderly Model (FEM)-an established dynamic microsimulation model of the health of Americans aged over 50 years-we estimate the changes in life expectancy, functional status and health care costs of obesity due to the introduction and widespread use of statins. RESULTS:Life expectancy gains of statins are estimated to be 5-6 % greater for obese individuals than for healthy-weight individuals, but most of these additional gains are associated with some level of disability. Considering both medical spending and the value of quality-adjusted life-years, statins do not significantly alter the costs of class 1 and 2 obesity (body mass index [BMI] ?30 and ?35 kg/m(2), respectively) and they increase the costs of class 3 obesity (BMI ?40 kg/m(2)) by 1.2 %. CONCLUSIONS:Although statins are very effective medications for lowering the risk of obesity-associated illnesses, they do not significantly reduce the costs of obesity.

SUBMITTER: Gaudette E

PROVIDER: S-EPMC4490078 | biostudies-literature | 2015 Jul

REPOSITORIES: biostudies-literature

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Do Statins Reduce the Health and Health Care Costs of Obesity?

Gaudette Étienne É Goldman Dana P DP Messali Andrew A Sood Neeraj N

PharmacoEconomics 20150701 7

<h4>Context</h4>Obesity impacts both individual health and, given its high prevalence, total health care spending. However, as medical technology evolves, health outcomes for a number of obesity-related illnesses improve. This article examines whether medical innovation can mitigate the adverse health and spending associated with obesity, using statins as a case study. Because of the relationship between obesity and hypercholesterolaemia, statins play an important role in the medical management ...[more]

PMID: 25576147

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Project description:BACKGROUND AND OBJECTIVES:An understanding of the health care resource use associated with AKI is needed to frame the investment and cost-effectiveness of strategies to prevent AKI and promote kidney recovery. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS:We assembled population-based cohort of adults hospitalized in Alberta between November of 2002 and March of 2009 without ESRD or an eGFR<15 ml/min per 1.73 m2. Outpatient serum creatinine measurements 6 months preceding admission defined baseline kidney function, and serum creatinine during the first 14 days of hospitalization defined Acute Kidney Injury Network stage; kidney recovery defined as serum creatinine within 25% of baseline and independence from dialysis was assessed at 90 days after AKI. Health care utilization and costs (in 2015 Canadian dollars) were determined from inpatient, outpatient, and physician claims datasets during the index hospitalization, recovery period (90 days post-AKI assessment), and 3-12 months post-AKI. A fully adjusted generalized linear model regression analysis was used to estimate costs associated with AKI. RESULTS:Of 239,906 hospitalized subjects, 25,495 (10.6%), 4598 (1.9%), 2493 (1.0%), and 670 (0.3%) had Acute Kidney Injury Network stages 1, 2, 3 without dialysis, and 3 with dialysis, respectively. Greater severity of AKI was associated with incremental increases in length of stay (+2.8; 95% confidence interval, 1.4 to 4.3 to +7.4; 95% confidence interval, 7.2 to 7.5 days) and costs (+$3779; 95% confidence interval, $3555 to $4004 to +$18,291; 95% confidence interval, $15,573 to $21,009 Canadian dollars) from admission to recovery assessment (3 months). At months 3-12 postadmission, compared with subjects without AKI, AKI with kidney recovery and AKI without kidney recovery were associated with incremental costs of +$2912-$3231 and +$6035-$8563 Canadian dollars, respectively. The estimated incremental cost of AKI in Canada is estimated to be over $200 million Canadian dollars per year. CONCLUSIONS:Severity of AKI, need for dialysis, and lack of kidney recovery are associated with significant health care costs in hospitalized patients and persist a year after admission. Strategies to identify, prevent, and facilitate kidney recovery are needed.

Project description:BackgroundSurgery risks increase when electricity is accessible but unreliable. During unreliable electricity events and without data on increased risk to patients, medical professionals base their decisions on anecdotal experience. Decisions should be made based on a cost-benefit analysis, but no methodology exists to quantify these risks, the associated hidden costs, nor risk charts to compare alternatives.MethodsTwo methodologies were created to quantify these hidden costs. In the first methodology through research literature and/or measurements, the authors obtained and analyzed a year's worth of hour-by-hour energy failures for four energy healthcare system (EHS) types in four regions (SolarPV in Iraq, Hydroelectric in Ghana, SolarPV+Wind in Bangladesh, and Grid+Diesel in Uganda). In the second methodology, additional patient risks were calculated according to time and duration of electricity failure and medical procedure impact type. Combining these methodologies, the cost from the Value of Statistical Lives lost divided by Energy shortage ($/kWh) is calculated for EHS type and region specifically. The authors define hidden costs due to electricity failure as VSL/E ($/kWh) and compare this to traditional electricity costs (always defined in $/kWh units), including Levelized Cost of Electricity (LCOE also in $/kWh). This is quantified into a fundamentally new energy healthcare system risk chart (EHS-Risk Chart) based on severity of event (probability of deaths) and likelihood of event (probability of electricity failure).ResultsVSL/E costs were found to be 10 to 10,000 times traditional electricity costs (electric utility or LCOE based). The single power source EHS types have higher risks than hybridized EHS types (especially as power loads increase over time), but all EHS types have additional risks to patients due to electricity failure (between 3 to 105 deaths per 1,000 patients).ConclusionsThese electricity failure risks and hidden healthcare costs can now be calculated and charted to make medical decisions based on a risk chart instead of anecdotal experience. This risk chart connects public health and electricity failure using this adaptable, scalable, and verifiable model.

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Do Statins Reduce the Health and Health Care Costs of Obesity?

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Do Statins Reduce the Health and Health Care Costs of Obesity?

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