Cost analyses of obesity in Canada: scope, quality, and implications

Cost Effectiveness and Resource Allocation

Paul J Veugelers¹  Arto Ohinmaa¹  Stefan Kuhle²  Amrita V Nair¹  Bach Xuan Tran¹ 

[1] School of Public Health, University of Alberta, Edmonton, AB, Canada;Department of Pediatrics, Obstetrics & Gynecology, Dalhousie University, Halifax, NS, Canada

关键词: Canada;    Intervention;    Cost;    Economic;    Overweight;    Obesity;   

Others  :  810774
DOI  :  10.1186/1478-7547-11-3

 received in 2012-07-18, accepted in 2013-01-27,  发布年份 2013

【 摘 要 】

Background

Rapid changes in lifestyle have led to a global obesity epidemic. Understanding the economic burden associated with the obesity epidemic is essential to decision making of cost-effective interventions. This study reviewed costs of obesity and intervention programs in Canada, assessed the scope and quality of existing cost analyses, and identified implications for economic evaluations and public health decision makers.

Methods

A systematic search of costs associated with obesity or intervention program in Canada between 1990 and 2011 yielded 10 English language articles eligible for review.

Results

The majority of studies was prevalence-based or top-down costing; 40% had excellent quality assessed using the Quality of Health Economic Study scale. The aggregated annual costs of obesity in Canada ranged from 1.27 to 11.08 billion dollars. Direct costs accounted for 37.2% to 54.5% of total annual costs. Between 2.2% and 12.0% of Canada's total health expenditures were attributable to obesity. The average annual physician cost of overweight male ($ 427) and female ($ 578) adults was lower than that of obese male ($ 475) and female ($ 682) adults; this cost differential across weight status groups was comparable to that found in adolescents. The cost for implementation and maintenance of a school-based obesity prevention program was $ 23 per student.

Conclusions

We observed high costs associated with overweight and obesity and modest costs for obesity prevention programs; however, no cost-effectiveness study of obesity interventions has been performed in Canada. Cost-effectiveness analyses of preventive programs that constitute incidence-based life-time modeling of costs and health outcomes from societal perspective are urgently needed.

【 授权许可】

   
2013 Tran et al; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Shields M, Carroll MD, CL O: Adult obesity prevalence in Canada and the United States. NCHS data brief, no 56 . Hyattsville, MD: National Center for Health Statistics; 2011.
• [2]Reilly JJ, Methven E, McDowell ZC, Hacking B, Alexander D, Stewart L, Kelnar CJ: Health consequences of obesity. Arch Dis Child 2003, 88:748-752.
• [3]Dietz WH: Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics 1998, 101:518-525.
• [4]Thompson D, Edelsberg J, Colditz GA, Bird AP, Oster G: Lifetime health and economic consequences of obesity. Arch Intern Med 1999, 159:2177-2183.
• [5]Trasande L, Elbel B: The economic burden placed on healthcare systems by childhood obesity. Expert Rev Pharmacoecon Outcomes Res 2012, 12:39-45.
• [6]Roux L, Donaldson C: Economics and obesity: costing the problem or evaluating solutions? Obes Res 2004, 12:173-179.
• [7]Kuhle S, Kirk S, Ohinmaa A, Yasui Y, Allen AC, Veugelers PJ: Use and cost of health services among overweight and obese Canadian children. Int J Pediatr Obes 2011, 6:142-148.
• [8]Janssen I, Lam M, Katzmarzyk PT: Influence of overweight and obesity on physician costs in adolescents and adults in Ontario, Canada. Obes Rev 2009, 10:51-57.
• [9]Wolfenstetter SB: Future direct and indirect costs of obesity and the influence of gaining weight: results from the MONICA/KORA cohort studies, 1995-2005. Econ Hum Biol 2012, 10:127-138.
• [10]John J, Wolfenstetter SB, Wenig CM: An economic perspective on childhood obesity: recent findings on cost of illness and cost effectiveness of interventions. Nutrition 2012, 28:829-839.
• [11]Anis AH, Zhang W, Bansback N, Guh DP, Amarsi Z, Birmingham CL: Obesity and overweight in Canada: an updated cost-of-illness study. Obes Rev 2009, 11:31-40.
• [12]John J, Wenig CM, Wolfenstetter SB: Recent economic findings on childhood obesity: cost-of-illness and cost-effectiveness of interventions. Curr Opin Clin Nutr Metab Care 2010, 13:305-313.
• [13]Pelone F, Specchia ML, Veneziano MA, Capizzi S, Bucci S, Mancuso A, Ricciardi W, de Belvis AG: Economic impact of childhood obesity on health systems: a systematic review. Obes Rev 2012, 13:431-440.
• [14]Withrow D, Alter DA: The economic burden of obesity worldwide: a systematic review of the direct costs of obesity. Obes Rev 2011, 12:131-141.
• [15]Fung C, Kuhle S, Lu C, Purcell M, Schwartz M, Storey K, Veugelers PJ: From "best practice" to "next practice": the effectiveness of school-based health promotion in improving healthy eating and physical activity and preventing childhood obesity. Int J Behav Nutr Phys Act 2012, 9:27. BioMed Central Full Text
• [16]Ross R, Blair SN, Godwin M, Hotz S, Katzmarzyk PT, Lam M, Levesque L, Macdonald S: Prevention and Reduction of Obesity through Active Living (PROACTIVE): rationale, design and methods. Br J Sports Med 2009, 43:57-63.
• [17]Thomas H: Obesity prevention programs for children and youth: why are their results so modest? Health Educ Res 2006, 21:783-795.
• [18]Ofman JJ, Sullivan SD, Neumann PJ, Chiou CF, Henning JM, Wade SW, Hay JW: Examining the value and quality of health economic analyses: implications of utilizing the QHES. J Manag Care Pharm 2003, 9:53-61.
• [19]Au F, Prahardhi S, Shiell A: Reliability of two instruments for critical assessment of economic evaluations. Value Health 2008, 11:435-439.
• [20]Gerkens S, Crott R, Cleemput I, Thissen JP, Closon MC, Horsmans Y, Beguin C: Comparison of three instruments assessing the quality of economic evaluations: a practical exercise on economic evaluations of the surgical treatment of obesity. Int J Technol Assess Health Care 2008, 24:318-325.
• [21]Ohinmaa A, Langille JL, Jamieson S, Whitby C, Veugelers PJ: Costs of implementing and maintaining comprehensive school health: the case of the Annapolis Valley Health Promoting Schools program. Can J Public Health 2011, 102:451-454.
• [22]Birmingham CL, Muller JL, Palepu A, Spinelli JJ, Anis AH: The cost of obesity in Canada. CMAJ 1999, 160:483-488.
• [23]Patra J, Popova S, Rehm J, Bondy S, Flint R, Giesbrecht N: Economic Cost of Chronic Disease in Canada: 1995–2003. The Ontario Chronic Disease Prevention Alliance and the Ontario Public Health Association 2007. Available at http://www.ocdpa.on.ca/OCDPA/docs/OCDPA_EconomicCosts.pdf webcite (accessed on 01 May 2012)
• [24]Finkelstein MM: Obesity, cigarette smoking and the cost of physicians' services in Ontario. Can J Public Health 2001, 92:437-440.
• [25]Carter R, Moodie M, Markwick A, Magnus A, Vos T, Swinburn B, Haby MM: Assessing cost-effectiveness in obesity (ACE-obesity): an overview of the ACE approach, economic methods and cost results. BMC Public Health 2009, 9:419. BioMed Central Full Text
• [26]Moffatt E, Shack LG, Petz GJ, Sauve JK, Hayward K, Colman R: The cost of obesity and overweight in 2005: a case study of Alberta, Canada. Can J Public Health 2011, 102:144-148.
• [27]Tarride JE, Haq M, Taylor VH, Sharma AM, Nakhai-Pour HR, O'Reilly D, Xie F, Dolovich L, Goeree R: Health status, hospitalizations, day procedures, and physician costs associated with body mass index (BMI) levels in Ontario, Canada. Clinicoecon Outcomes Res 2012, 4:21-30.
• [28]Katzmarzyk PT, Janssen I: The economic costs associated with physical inactivity and obesity in Canada: an update. Can J Appl Physiol 2004, 29:90-115.