Presentation (CTI)

OBJECTIVES: Obesity is a major risk factor for multiple chronic diseases and contributes substantially to healthcare expenditures. However, evidence on the economic burden of obesity in the Republic of Srpska remains limited. This study aimed to estimate the direct healthcare costs attributable to obesity-related comorbidities in the Bosnia and Herzegovinas Entity Republka Srpska (RS).
METHODS: A prevalence-based cost-of-illness model was developed from the public healthcare payer perspective. Adult obesity prevalence estimates were obtained from published epidemiological studies in Bosnia and Herzegovina and applied to the RS population. Ten obesity-related comorbidities were included: diabetes mellitus, angina, sleep apnea, asthma, dyslipidemia, atrial fibrillation, hypertension, chronic kidney disease, osteoarthritis, and heart failure. Annual per-patient costs were derived from local healthcare resource utilization and reimbursement data and converted to 2025 Euros (€). Obesity-attributable fractions were applied using a Population Attributable Fraction (PAF) approach based on published European relative risk estimates. Costs related to obesity treatment were excluded.
RESULTS: Annual per-patient costs ranged from €204 (osteoarthritis) to €1,150 (heart failure), with cardiovascular and metabolic diseases representing the main cost drivers. Using a prevalence-based modelling approach, the annual direct healthcare costs attributable to obesity-related comorbidities in the Republic of Srpska were estimated at €24.7 million, with sensitivity analyses ranging from €22.3 million to €27.2 million.
CONCLUSIONS: Obesity imposes a considerable economic burden on the healthcare system of the RS, primarily driven by cardiovascular, metabolic, and musculoskeletal comorbidities. Strengthening prevention and obesity management strategies may reduce future healthcare expenditures and improve population health outcomes. These findings support evidence-based healthcare planning and resource allocation.