Understanding Drivers on Healthcare Resource Utilization Costs Among People Living With Obesity in UK Clinical Practice
Author(s)
Jonathan Pearson-Stuttard, MA, MSc, PhD, MD1, Sara Holloway, MSc1, João Fernandes, MSc2, Saniya Deshpande, MSc1, Alice Beattie, MA1.
1Lane Clark & Peacock LLP, London, United Kingdom, 2Novo Nordisk A/S, Søborg, Denmark.
1Lane Clark & Peacock LLP, London, United Kingdom, 2Novo Nordisk A/S, Søborg, Denmark.
OBJECTIVES: We estimated contributions of key demographic and clinical characteristics on HCRU (healthcare resource utilisation) and costs among people living with obesity.
METHODS: Linear regression modelling assessed associations between obesity-related complications (ORCs), sociodemographics, BMI class, and HCRU costs - both total and across healthcare settings (primary care, inpatient care, outpatient care, emergency department visits and prescriptions). Analysis used 2023 data from Discover, a linked electronic health record database of 2.8 million North-West London residents representative of the UK population by age and sex. Additional analysis for females included polycystic ovary syndrome (PCOS) and interaction terms between PCOS and age group.
RESULTS: In the obesity population (BMI ≥30kg/m2, n=287,497), the greatest drivers of HCRU costs were certain ORCs, including cancer (IRR=3.16, 95% confidence interval=3.02-3.31), type 2 diabetes (T2D; 2.66, 2.59-2.72), idiopathic intracranial hypertension (IIH; 2.15, 1.83-2.54), prediabetes (1.89, 1.85-1.94), hypertension (1.87, 1.83-1.91) and rheumatoid arthritis (1.84, 1.71-1.99). Amongst females, PCOS was associated with higher HCRU costs compared to those without PCOS (1.33, 1.27-1.38) in 18-55 year-olds. All age groups incurred higher HCRU costs compared to 18-25 year-olds, highest in 66-75 year-olds (1.77, 1.68-1.85). Compared to BMI 30-35kg/m2, BMI ≥40kg/m2 was associated with slight increased HCRU costs (1.08, 1.05-1.11), whilst the effect for BMI 35-40kg/m2 was not significant. Drivers of cost varied by HCRU setting, with cancer being the greatest driver of total HCRU costs (3.16, 3.02-3.31), inpatient care (37.89, 34.68-41.40) and outpatient care costs (53.09, 48.22-58.45); T2D for primary care (2.65, 2.59-2.71) and prescription costs (6.55, 6.33-6.78); and deep vein thrombosis/pulmonary embolism for emergency department costs (3.65, 3.30-4.03).
CONCLUSIONS: The majority of ORCs and sociodemographics are substantial drivers of HCRU cost in people with obesity, whilst BMI class has a comparatively lower impact. Cost drivers vary by healthcare setting, informing targeted interventions towards where unmet needs are highest.
METHODS: Linear regression modelling assessed associations between obesity-related complications (ORCs), sociodemographics, BMI class, and HCRU costs - both total and across healthcare settings (primary care, inpatient care, outpatient care, emergency department visits and prescriptions). Analysis used 2023 data from Discover, a linked electronic health record database of 2.8 million North-West London residents representative of the UK population by age and sex. Additional analysis for females included polycystic ovary syndrome (PCOS) and interaction terms between PCOS and age group.
RESULTS: In the obesity population (BMI ≥30kg/m2, n=287,497), the greatest drivers of HCRU costs were certain ORCs, including cancer (IRR=3.16, 95% confidence interval=3.02-3.31), type 2 diabetes (T2D; 2.66, 2.59-2.72), idiopathic intracranial hypertension (IIH; 2.15, 1.83-2.54), prediabetes (1.89, 1.85-1.94), hypertension (1.87, 1.83-1.91) and rheumatoid arthritis (1.84, 1.71-1.99). Amongst females, PCOS was associated with higher HCRU costs compared to those without PCOS (1.33, 1.27-1.38) in 18-55 year-olds. All age groups incurred higher HCRU costs compared to 18-25 year-olds, highest in 66-75 year-olds (1.77, 1.68-1.85). Compared to BMI 30-35kg/m2, BMI ≥40kg/m2 was associated with slight increased HCRU costs (1.08, 1.05-1.11), whilst the effect for BMI 35-40kg/m2 was not significant. Drivers of cost varied by HCRU setting, with cancer being the greatest driver of total HCRU costs (3.16, 3.02-3.31), inpatient care (37.89, 34.68-41.40) and outpatient care costs (53.09, 48.22-58.45); T2D for primary care (2.65, 2.59-2.71) and prescription costs (6.55, 6.33-6.78); and deep vein thrombosis/pulmonary embolism for emergency department costs (3.65, 3.30-4.03).
CONCLUSIONS: The majority of ORCs and sociodemographics are substantial drivers of HCRU cost in people with obesity, whilst BMI class has a comparatively lower impact. Cost drivers vary by healthcare setting, informing targeted interventions towards where unmet needs are highest.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
MSR209
Topic
Methodological & Statistical Research
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity)