Healthcare Costs and Resource Utilization Associated With Knee Osteoarthritis and Obesity in the United States: A Retrospective Database Study
Author(s)
Magaly Perez-Nieves, MPH, PhD, Sylvia Gonsahn-Bollie, MD, David Schapiro, PharmD, Kendra Terrell, MPH, Ahong Huang, MS, Alexandra C Meeks, MPH;
Eli Lilly and Company, Indianapolis, IN, USA
Eli Lilly and Company, Indianapolis, IN, USA
Presentation Documents
OBJECTIVES: To describe healthcare costs and resource utilization among people with knee osteoarthritis (OA-K) and obesity in the United States.
METHODS: This retrospective, observational study used Optum’s de-identified Market Clarity Data, which deterministically links medical and pharmacy claims with electronic health record data from providers across the continuum of care, for adults (≥45 years) with ≥1 diagnosis for OA-K between October 1, 2016, and March 31, 2023, moderate-to-severe OA-K pain, and BMI ≥30 kg/m2 (30-day lookback from OA-K diagnosis date). All participants had continuous enrollment in a commercial or Medicare plan for 1 year before and after OA-K diagnosis. Total medical and pharmacy costs were described in the first year after OA-K diagnosis, stratified by BMI categories: Class 1 obesity (≥30 to <35 kg/m2), Class 2 obesity (≥35 to <40 kg/m2), and Class 3 obesity (≥40 kg/m2).
RESULTS: Of 78,246 participants, 46.2% had Class 1, 28.6% had Class 2, and 25.2% had Class 3 obesity. Among those with available data, mean (SD) total medical costs in the first year after OA-K diagnosis were greater in Class 2 ($28,634 [50,134]) and Class 3 obesity ($29,727 [50,294]) compared to Class 1 obesity ($26,350 [44,793]). Mean (SD) total pharmacy costs were also greater among Class 2 ($8,328 [30,487] and Class 3 obesity ($11,078 [67,852]) compared to Class 1 obesity ($7,259 [34,861]). Across Class 1, 2, and 3 obesity, among participants with ≥1 visit, the mean (SD) number of outpatient visits (22.4 [17.4], n=36,085; 23.2 [17.7], n=22,338; and 23.4 [18.0], n=19,656, respectively), inpatient visits (2.1 [3.3], n=9,788; 2.2 [3.9], n=6,502; 2.4 [4.2], n=5,785), and total number of inpatient days (8.5 [27.1], 8.8 [32.5], 11.0 [36.7]) in the first year after OA-K diagnosis were greater in higher BMI categories.
CONCLUSIONS: Increasing healthcare costs and resource utilization were observed with increasing obesity class during the first year after OA-K diagnosis.
METHODS: This retrospective, observational study used Optum’s de-identified Market Clarity Data, which deterministically links medical and pharmacy claims with electronic health record data from providers across the continuum of care, for adults (≥45 years) with ≥1 diagnosis for OA-K between October 1, 2016, and March 31, 2023, moderate-to-severe OA-K pain, and BMI ≥30 kg/m2 (30-day lookback from OA-K diagnosis date). All participants had continuous enrollment in a commercial or Medicare plan for 1 year before and after OA-K diagnosis. Total medical and pharmacy costs were described in the first year after OA-K diagnosis, stratified by BMI categories: Class 1 obesity (≥30 to <35 kg/m2), Class 2 obesity (≥35 to <40 kg/m2), and Class 3 obesity (≥40 kg/m2).
RESULTS: Of 78,246 participants, 46.2% had Class 1, 28.6% had Class 2, and 25.2% had Class 3 obesity. Among those with available data, mean (SD) total medical costs in the first year after OA-K diagnosis were greater in Class 2 ($28,634 [50,134]) and Class 3 obesity ($29,727 [50,294]) compared to Class 1 obesity ($26,350 [44,793]). Mean (SD) total pharmacy costs were also greater among Class 2 ($8,328 [30,487] and Class 3 obesity ($11,078 [67,852]) compared to Class 1 obesity ($7,259 [34,861]). Across Class 1, 2, and 3 obesity, among participants with ≥1 visit, the mean (SD) number of outpatient visits (22.4 [17.4], n=36,085; 23.2 [17.7], n=22,338; and 23.4 [18.0], n=19,656, respectively), inpatient visits (2.1 [3.3], n=9,788; 2.2 [3.9], n=6,502; 2.4 [4.2], n=5,785), and total number of inpatient days (8.5 [27.1], 8.8 [32.5], 11.0 [36.7]) in the first year after OA-K diagnosis were greater in higher BMI categories.
CONCLUSIONS: Increasing healthcare costs and resource utilization were observed with increasing obesity class during the first year after OA-K diagnosis.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE477
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), SDC: Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal)