Quantifying the Economic Consequences of Childhood Obesity and Potential Benefits of Interventions

Leonardo Trasande

Disclosures

Expert Rev Pharmacoeconomics Outcomes Res. 2011;11(1):47-50. 

In This Article

Abstract and Introduction

Abstract

The article under evaluation analyzed healthcare utilization data from the German Interview and Examination Survey for Children and Adolescents, a representative cross-sectional survey that quantifies healthcare services and costs by category. The author used widely accepted health economic methods to quantify incremental costs and utilization attributable to elevated BMI in children. There are important limits to consider for policy makers, clinicians and others who may use these data in isolation to quantify economic savings and other benefits to quantify cost–effectiveness and cost–benefit profiles of environmental, dietary, physical activity and/or pharmaceutical interventions to prevent or treat obesity in childhood. Longer term benefits of preventing obesity in childhood must be considered.

Introduction

Obesity is a major cause of morbidity among children, especially in the developed world. Diabetes, slipped capital femoral epiphysis,[1] gallbladder disease[2] and obstructive sleep apnea[3] are among the conditions associated with obesity in childhood.[4] Until recently, few studies had quantified the impact of obesity on healthcare utilization and expenditures during childhood. Hampl et al. found that children in a large pediatric integrated delivery system diagnosed with obesity during a healthy-child visit had US$172 higher annual healthcare expenditures than children with a normal BMI.[5] An analysis of the 2001–2003 Medical Expenditure Panel Survey (MEPS) identified that overweight children, defined by the American Medical Association Expert Committee and other national associations as children with a BMI in the 85–94th percentile for age and sex,[101] had annual total healthcare expenditures US$180 higher than children with a normal BMI, while obese children, or children with a BMI in the 95th percentile or greater for age and sex, had US$220 higher expenditures on average.[6]

The components of healthcare utilization that contribute to these increased costs are becoming increasingly understood. Charges and costs have been found to be elevated among children hospitalized with a diagnosis of obesity.[7–9] Estabrooks and Shetterly have found increased mental health and sick visits among overweight children in one integrated nonprofit healthcare system,[10] and using data from the 2001–2004 MEPS, Trasande and Chatterjee found US$2.9 billion in incremental prescription drug, outpatient visit and emergency room costs that can be attributed to elevated BMI in children.[11]

Analyses of the economic consequences of childhood obesity have, to date, largely been limited to the USA. It is therefore highly appropriate that Wenig used a representative survey of German children to examine the impact of elevated BMI on healthcare utilization and costs across physician visit, therapist visit and hospital visit subcategories.[12] These data can inform decisions by policy makers in Germany and other similar countries in the EU to quantify whether investment in obesity prevention or treatment options intervention would be worth considering.

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