Abstract：
Obesity-related comorbidities (ORCs) cause significant economic and clinical burdens for people with obesity and the US health care system. A reduction in weight at the population level may reduce incident ORC diagnoses and associated costs of treatment. The aim of this work is to describe obesity burden in the United States through the prevalence and direct treatment costs of ORCs, as well as the clinical and economic value of 15% weight loss in a population of adults with obesity. The IQVIA Ambulatory US electronic medical record database was used to create a cohort (7,667,023 individuals 20-69 years of age, body mass index of 30-50 kg/m2), utilized to characterize the prevalence of 10 ORCs. Direct treatment costs were collected from literature reports. A risk model was leveraged to estimate the number and cost of additional ORC diagnoses over 5 years from baseline through two scenarios: stable weight and 15% lower body weight at baseline for all members of the population. Prevalence, incidence, and cost data were scaled down to a representative subset of 100,000 individuals. In 2022, the annual treatment costs for all 10 ORCs exceeded $918 million for the representative cohort. In a stable-weight scenario, these costs were estimated to increase to ≈$1.4 billion by 2027. With 15% lower body weight at baseline, $221 million in cumulative savings was estimated, corresponding to $2205 in savings/patient over 5 years. Consequently, weight loss in this population may correspond to significantly reduced numbers of incident ORC complications translating to substantial cost savings.
摘要：
肥胖相关的合并症（ORC）对肥胖患者和美国医疗保健系统造成重大的经济和临床负担。在人群水平上体重的减少可以减少意外ORC诊断和相关的治疗成本。这项工作的目的是通过ORC的患病率和直接治疗成本来描述美国的肥胖负担，以及在肥胖的成年人群中减少15％体重的临床和经济价值。IQVIA门诊美国电子病历数据库用于创建一个队列（7,667,023名20-69岁的个体，体重指数为30-50kg/m2)，用于表征10个ORC的患病率。从文献报告中收集直接治疗费用。利用风险模型通过两种情况估计从基线开始的5年内额外ORC诊断的数量和成本：基线时所有人群的体重稳定和体重降低15％。患病率,发病率,成本数据被缩减为10万人的代表性子集。2022年，代表队列中所有10个ORC的年度治疗费用超过9.18亿美元。在重量稳定的情况下，到2027年，这些成本估计将增加到约14亿美元。基线时体重降低15%，估计累计节省了2.21亿美元，相当于2205美元的储蓄/患者超过5年。因此,该人群的体重减轻可能与ORC并发症的发生率显着减少相对应，从而节省了大量成本。
