Modeling the clinical and economic implications of obesity using microsimulation
Open accessAbstract
OBJECTIVES: The obesity epidemic has raised considerable public health concerns, but there are few validated longitudinal simulation models examining the human and economic cost of obesity. This paper describes a microsimulation model as a comprehensive tool to understand the relationship between body weight, health, and economic outcomes. METHODS: Patient health and economic outcomes were simulated annually over 10 years using a Markov-based microsimulation model. The obese population examined is nationally representative of obese adults in the US from the 2005-2012 National Health and Nutrition Examination Surveys, while a matched normal weight population was constructed to have similar demographics as the obese population during the same period. Prediction equations for onset of obesity-related comorbidities, medical expenditures, economic outcomes, mortality, and quality-of-life came from published trials and studies supplemented with original research. Model validation followed International Society for Pharmacoeconomics and Outcomes Research practice guidelines. RESULTS: Among surviving adults, relative to a matched normal weight population, obese adults averaged $3900 higher medical expenditures in the initial year, growing to $4600 higher expenditures in year 10. Obese adults had higher initial prevalence and higher simulated onset of comorbidities as they aged. Over 10 years, excess medical expenditures attributed to obesity averaged $4280 annually-ranging from $2820 for obese category I to $5100 for obese category II, and $8710 for obese category III. Each excess kilogram of weight contributed to $140 higher annual costs, on average, ranging from $136 (obese I) to $152 (obese III). Poor health associated with obesity increased work absenteeism and mortality, and lowered employment probability, personal income, and quality-of-life. CONCLUSIONS: This validated model helps illustrate why obese adults have higher medical and indirect costs relative to normal weight adults, and shows that medical costs for obese adults rise more rapidly with aging relative to normal weight adults.
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In this study we used a previously published and validated microsimulation model to estimate reduced CVD events onset and health expenditure by senior participants of a digital intensive behavioral counseling program.
“In this study we used a previously published and validated microsimulation model to estimate reduced CVD events onset and health expenditure by senior participants of a digital intensive behavioral counseling program.”
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- Authors
- Su, W., Huang, J., Chen, F., Iacobucci, W., Mocarski, M., Dall, T. M., & Perreault, L.
- Affiliations
- Novo Nordisk Canada (Canada) (CA)
- University of Colorado Anschutz (US)
- Corresponding author
- Su, W.
- Venue
- Journal of Medical Economics
- Publisher
- Informa UK Limited
- Published
- 2015-08-13
- Volume
- 18
- Issue
- 11
- Pages
- 886-897
- ISSN
- 1369-6998 (ISSN-L)
- 1941-837X
- OpenAlex
- W1852003516
- Cited by
- 55
- References
- 11
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 15 · 2023: 4 · 2022: 4 · 2021: 4 · 2020: 5 · 2019: 4 · 2018: 3 · 2017: 3 · 2016: 4 · 2015: 1
- FWCI
- 3.93
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Medical Economics (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Novo Nordisk
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Keywords
- obesity, economic burden of obesity, health care costs, obesity-related comorbidities, quality of life, mortality, absenteeism, employment probability, personal income, body weight, microsimulation model, Markov model, indirect costs
- MeSH terms
- Absenteeism, Adult, Aged, Aging, Body Weight, Costs and Cost Analysis, Depressive Disorder, Major, Major Depressive Disorder, Employment, Female, Health Services, Humans, Income, Male, Markov Chains, Middle Aged, Obesity, Quality of Life, Sleep Apnea Syndromes, Socioeconomic Factors, Comorbidity, Body Mass Index, Cost of Illness
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