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Healthcare costs associated with change in body mass index in patients with type 2 diabetes mellitus in Spain: the ECOBIM study.

Dilla T, Valladares A, Nicolay C, Salvador J, Reviriego J, Costi M - Appl Health Econ Health Policy (2012)

Bottom Line: One-unit gain (or loss) in BMI was significantly (p < 0.001) associated with a 2.4% cost increase (or decrease) [one-slope model].The economic benefit associated with reducing one BMI unit was 9.4% cost decrease in obese and 2.7% in non-obese patients (4-slope model).A reduction in BMI was associated with appreciable short-term economic benefits, especially in obese patients.

View Article: PubMed Central - PubMed

Affiliation: Medical Department, Lilly, Alcobendas, Madrid, Spain. dilla_tatiana@lilly.com

ABSTRACT

Background: Weight management is considered a key therapeutic strategy in type 2 diabetes mellitus. However, little is known about the impact of weight loss or body mass index (BMI) reduction on type 2 diabetes-related healthcare costs.

Objective: The aim of this study was to estimate the economic impact of change in BMI among patients with type 2 diabetes mellitus from the Spanish healthcare system perspective.

Methods: The ECOBIM study is an observational, non-interventional study in which data on BMI change and costs incurred by patients with type 2 diabetes were collected cross-sectionally and retrospectively for a 12-month period. Generalized linear mixed models were applied to estimate the effects of (i) BMI change in general (one-slope model); (ii) BMI gain and no BMI gain (two-slope model); and (iii) BMI gain and no BMI gain among obese and non-obese patients (four-slope model).

Results: We studied 738 patients with a mean (SD) age of 66 (11) years and BMI of 30.6 (5.2) kg/m2. During the 12-month study period, 41.2% of patients gained BMI (BMI gainers) and 58.8% experienced either loss (52.2%) or no change (6.6%) in BMI (non-BMI gainers). One-unit gain (or loss) in BMI was significantly (p < 0.001) associated with a 2.4% cost increase (or decrease) [one-slope model]. Every unit gain in BMI was associated with a 20.0% increase in costs among BMI gainers while losing one unit was associated with an 8.0% decrease in costs among non-BMI gainers (two-slope model, p < 0.01). The economic benefit associated with reducing one BMI unit was 9.4% cost decrease in obese and 2.7% in non-obese patients (4-slope model).

Conclusion: An increase in BMI among patients with type 2 diabetes was associated with increased 1-year direct healthcare costs. A reduction in BMI was associated with appreciable short-term economic benefits, especially in obese patients.

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Relative change in 1-year direct healthcare costs in the three GLMM analyses
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Tab4: Relative change in 1-year direct healthcare costs in the three GLMM analyses

Mentions: In model 1 (one-slope model), a unit gain in BMI was statistically significantly (p ≪ 0.001) associated with an increase of 2.4% in total direct costs (figure 2 and table IV). When the effects of BMI gain and no BMI gain during the study reference period were assessed separately for BMI gainers and non-BMI gainers (model 2, two-slope model), a one-unit change in BMI was associated in BMI gainers with a 20.0% increase in costs, but in non-BMI gainers with an 8.0% decrease in costs (p ≪ 0.01 for the comparison of subgroups, table IV).Table IV


Healthcare costs associated with change in body mass index in patients with type 2 diabetes mellitus in Spain: the ECOBIM study.

Dilla T, Valladares A, Nicolay C, Salvador J, Reviriego J, Costi M - Appl Health Econ Health Policy (2012)

Relative change in 1-year direct healthcare costs in the three GLMM analyses
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4269888&req=5

Tab4: Relative change in 1-year direct healthcare costs in the three GLMM analyses
Mentions: In model 1 (one-slope model), a unit gain in BMI was statistically significantly (p ≪ 0.001) associated with an increase of 2.4% in total direct costs (figure 2 and table IV). When the effects of BMI gain and no BMI gain during the study reference period were assessed separately for BMI gainers and non-BMI gainers (model 2, two-slope model), a one-unit change in BMI was associated in BMI gainers with a 20.0% increase in costs, but in non-BMI gainers with an 8.0% decrease in costs (p ≪ 0.01 for the comparison of subgroups, table IV).Table IV

Bottom Line: One-unit gain (or loss) in BMI was significantly (p < 0.001) associated with a 2.4% cost increase (or decrease) [one-slope model].The economic benefit associated with reducing one BMI unit was 9.4% cost decrease in obese and 2.7% in non-obese patients (4-slope model).A reduction in BMI was associated with appreciable short-term economic benefits, especially in obese patients.

View Article: PubMed Central - PubMed

Affiliation: Medical Department, Lilly, Alcobendas, Madrid, Spain. dilla_tatiana@lilly.com

ABSTRACT

Background: Weight management is considered a key therapeutic strategy in type 2 diabetes mellitus. However, little is known about the impact of weight loss or body mass index (BMI) reduction on type 2 diabetes-related healthcare costs.

Objective: The aim of this study was to estimate the economic impact of change in BMI among patients with type 2 diabetes mellitus from the Spanish healthcare system perspective.

Methods: The ECOBIM study is an observational, non-interventional study in which data on BMI change and costs incurred by patients with type 2 diabetes were collected cross-sectionally and retrospectively for a 12-month period. Generalized linear mixed models were applied to estimate the effects of (i) BMI change in general (one-slope model); (ii) BMI gain and no BMI gain (two-slope model); and (iii) BMI gain and no BMI gain among obese and non-obese patients (four-slope model).

Results: We studied 738 patients with a mean (SD) age of 66 (11) years and BMI of 30.6 (5.2) kg/m2. During the 12-month study period, 41.2% of patients gained BMI (BMI gainers) and 58.8% experienced either loss (52.2%) or no change (6.6%) in BMI (non-BMI gainers). One-unit gain (or loss) in BMI was significantly (p < 0.001) associated with a 2.4% cost increase (or decrease) [one-slope model]. Every unit gain in BMI was associated with a 20.0% increase in costs among BMI gainers while losing one unit was associated with an 8.0% decrease in costs among non-BMI gainers (two-slope model, p < 0.01). The economic benefit associated with reducing one BMI unit was 9.4% cost decrease in obese and 2.7% in non-obese patients (4-slope model).

Conclusion: An increase in BMI among patients with type 2 diabetes was associated with increased 1-year direct healthcare costs. A reduction in BMI was associated with appreciable short-term economic benefits, especially in obese patients.

Show MeSH
Related in: MedlinePlus