The substantial costs to society associated with obesity – a Danish register-based study based on 2002-2018 data

ABSTRACT

Introduction

The Danish national health registers were used to investigate the economic burden of obesity, associated costs of comorbidities and a breakdown into direct and indirect costs.

Methods

The study population comprised all Danish adult citizens registered with a hospital diagnosis of obesity in the Danish National Patient Register between 2002 and 2018. Cases were matched with five controls via the Danish Civil Registration System. We estimated the difference in total healthcare costs and indirect costs between cases and controls and the difference in healthcare resource utilization. In a sub-analysis, we estimated total healthcare costs for persons who had been registered with one or more of 11 predefined comorbidities.

Results

People with obesity experienced a statistically significant twofold increase in average direct healthcare costs per year (EUR 5,934), compared with controls (EUR 2,788) and had statistically significantly higher indirect costs compared to controls. Total healthcare costs for people with obesity and one or more of the 11 comorbidities were 91.7%–342.8% higher than total healthcare costs of the population with obesity but none of the 11 comorbidities.

Conclusion

Obesity was associated with an increase in both direct and indirect costs. The presence of comorbidities was associated with additional healthcare costs.

Key points

• Obesity is associated with an increase in direct and indirect costs in Denmark.

• Comorbidities are associated with additional healthcare costs.

KEYWORDS:

• Burden of disease
• cost of illness
• obesity
• real-world evidence
• register-based study

Declaration of interest

U Panton and P Johansen are employees of Novo Nordisk North West Europe Pharmaceuticals A/S, Copenhagen, and shareholders of Novo Nordisk stocks. M Spanggaard, M Bøgelund, M Pedersen and S Reitzel are employees at Incentive, which is a paid vendor of Novo Nordisk North West Europe Pharmaceuticals. C Dirksen and N Jørgensen both sit on a Novo Nordisk advisory board and have further received lecture fees. C Dirksen has received support for attending a meeting/congress. N Jørgensen is a member of the board of the Danish Association for the Study of Obesity and is a shareholder of Novo Nordisk and Eli Lilly stocks. S Madsbad reports no conflict of interest. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Data availability statement

Data are available as presented in the manuscript. According to Danish legislation, our approvals to use Danish data for the current study do not permit us to share patient data or make it available to other parties. Researchers must apply for data access directly to Statistics Denmark through the Research Service.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

All authors contributed to the study design and interpretation of the results, and revision of the manuscript. Authors 1, 7 and 8 wrote the paper and conducted the analysis. Authors 3, 4 and 5 contributed with clinical expert input. All authors have approved the final version of the manuscript to be published and agree to be accountable for all aspects of the work.

Supplementary material

Supplemental data for this article can be accessed here

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Notes

1. Disease-specific prescription medicines include: ATC codes C01B including sublevels for patients with atrial fibrillation, ATC code: A10AE54, A10AE56 and A10B including sublevels excluding A10BJ02 for patients with diabetes type 2, ATC codes C02 including sublevels for patients with hypertension, and for asthma purchase of prescription medication with a labeled indication for asthma (indication codes 202, 203, 822 in the Danish National Prescription Registry) as well as ATC code: R03DC03.

Additional information

Funding

Research relating to this manuscript was funded by Novo Nordisk Denmark A/S, Region North West Europe.