The present paper represents a cost-of-illness analysis and describes, by calculation of the total cost, the health economic impact caused by obesity and its associated diseases in the Federal Republic of Germany within one reference year. A total cost of Euro 13.007 billion based on a discount rate of 4%, and costs amounting to 12.754 billion based on a discount rate of 6%, were calculated for obesity and 11 diseases identified as significantly associated with obesity. Direct costs accounted for 86.87 % (resp. 88.98 %) and indirect costs for 12.68 % (resp. 11.01%) of the total costs. The anti-obesity medications approved for sale in Germany, at Euro 56.65 million in prescriptions, represent the largest determinant of the direct costs of obesity in terms of individual diagnoses as defined by ICD-10 code E 65-68. These direct costs however, at Euro 85.71 million, represent only 0.66 % (0.67 %) of the total cost. Taking into account all the direct costs related to obesity, the resulting costs of diabetes mellitus stand out by far, at over Euro 6.814 billion, followed by the costs of cardiac and vascular diseases, amounting to Euro 1.92 billion, and osteoarthritis, at Euro 0.965 billion. In terms of indirect costs, disability accounts for the largest relative share, at 46 % or Euro 760.74 million (or 42 % and Euro 587.31 million, respectively), followed by incapacity to work, at 35 % (41 %) or (undiscounted) Euro 582.24 million. Mortality represents the lowest cost share at 19 % or Euro 313.29 million (17 % or Euro 234.46 million, respectively). The indirect costs include obesity (in 2003) that led to 48,960 disability cases, or 477,938 lost working years. Years lost in connection with incapacity to work amounted to 16,216, and due to premature deaths to 213,340. Possible developments calculated for the years to come indicate an urgent need for successful prevention measures if obesity costs are to remain manageable.
Today’s classification of body mass follows the recommendations of the WHO’s International Obesity Task Force (IOTF), which uses the Body Mass Index (BMI) as a basis. Obesity is defined as a BMI of ≥ 30, and this definition has meanwhile become generally accepted in western industrialised countries. Analysing obesity as the subject of a cost-of-illness study is currently a necessary as well as complex requirement. Obesity prevalence in Germany lies at over 20 per cent of the adult population, and even at over 30 per cent in some age groups, with children also increasingly affected.
A recently published health economic analysis of the costs associated with being overweight/obese, conducted in the region of Augsburg, has shown that obese persons generate costs some 70 per cent higher than those generated by people of normal weight, and severely obese persons (BMI ≥ 35) even 3-times-higher costs. It is not so much obesity on its own that is to be seen as the main determinant of the increased costs, but rather the associated risks that, in particular, facilitate certain diseases in their development and progression. The actual extent of the economic impact can be evaluated only by conducting cause-related research. The specific problem of calculating the total costs of obesity in Germany is, however, a subject area that involves uncertainties and unquestionably critical aspects. The ultimate aim, however, with the aid of assumptions, comparative calculations and extrapolations, is to provide understandable data suitable for discussion.
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The present paper represents a cost-of-illness analysis and describes, by calculation of the total cost, the health economic impact caused by obesity and its associated diseases in the Federal Republic of Germany within one reference year. A total cost of Euro 13.007 billion based on a discount rate of 4%, and costs amounting to 12.754 billion based on a discount rate of 6%, were calculated for obesity and 11 diseases identified as significantly associated with obesity. Direct costs accounted f...
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