DIRECT HEALTHCARE COSTS ATTRIBUTABLE TO OBESITY-RELATED COMORBIDITIES IN THE FEDERATION OF BOSNIA AND HERZEGOVINA
Author(s)
Tarik Catic, PhD1, Refet Gojak, PhD2.
1University SSST Sarajevo - Medical School, Sarajevo, Bosnia and Herzegovina, 2Clinical Center Univsity of Sarajevo, Sarajevo, Bosnia and Herzegovina.
1University SSST Sarajevo - Medical School, Sarajevo, Bosnia and Herzegovina, 2Clinical Center Univsity of Sarajevo, Sarajevo, Bosnia and Herzegovina.
OBJECTIVES: Obesity is associated with increased morbidity, healthcare resource utilization, and healthcare expenditure. Evidence on its economic burden in Bosnia and Herzegovina remains limited. This study aimed to estimate the direct healthcare costs attributable to obesity-related comorbidities in the Federation of Bosnia and Herzegovina (FBiH).
METHODS: A prevalence-based, deterministic cost-of-illness model was developed from the public healthcare payer perspective. Adult obesity prevalence was estimated at 21.2% using published epidemiological evidence for Bosnia and Herzegovina. Direct healthcare costs were assessed for ten major obesity-related comorbidities. Annual per-patient costs were derived from healthcare resource utilization and reimbursement data from FBiH and converted to 2025 Euros (€). Costs associated with obesity treatment itself were excluded. Due to limited availability of disease-specific epidemiological and utilization data, a model-based approach was employed. Obesity-attributable fractions and epidemiological assumptions were adapted from published European cost-of-illness studies and applied to local cost estimates.
RESULTS: Annual direct healthcare costs per patient ranged from €497 for sleep apnea to €2,524 for angina. The highest costs were observed for angina (€2,524), heart failure (€2,476), diabetes mellitus (€1,984), and osteoarthritis (€1,864). Using a prevalence-based modelling approach and obesity-attributable risk estimates from European studies, annual direct healthcare costs attributable to obesity-related comorbidities in FBiH were estimated at €121 million. Sensitivity analyses yielded a range between €109 million and €133 million annually. Cardiovascular and metabolic diseases were the primary drivers of overall expenditure.
CONCLUSIONS: Obesity imposes a substantial economic burden on the healthcare system of FBiH through increased prevalence and management of chronic diseases. The estimated annual burden of €121 million highlights obesity as an important public health and healthcare financing challenge. Investments in prevention and effective obesity management may reduce future healthcare expenditures and improve population health outcomes.
METHODS: A prevalence-based, deterministic cost-of-illness model was developed from the public healthcare payer perspective. Adult obesity prevalence was estimated at 21.2% using published epidemiological evidence for Bosnia and Herzegovina. Direct healthcare costs were assessed for ten major obesity-related comorbidities. Annual per-patient costs were derived from healthcare resource utilization and reimbursement data from FBiH and converted to 2025 Euros (€). Costs associated with obesity treatment itself were excluded. Due to limited availability of disease-specific epidemiological and utilization data, a model-based approach was employed. Obesity-attributable fractions and epidemiological assumptions were adapted from published European cost-of-illness studies and applied to local cost estimates.
RESULTS: Annual direct healthcare costs per patient ranged from €497 for sleep apnea to €2,524 for angina. The highest costs were observed for angina (€2,524), heart failure (€2,476), diabetes mellitus (€1,984), and osteoarthritis (€1,864). Using a prevalence-based modelling approach and obesity-attributable risk estimates from European studies, annual direct healthcare costs attributable to obesity-related comorbidities in FBiH were estimated at €121 million. Sensitivity analyses yielded a range between €109 million and €133 million annually. Cardiovascular and metabolic diseases were the primary drivers of overall expenditure.
CONCLUSIONS: Obesity imposes a substantial economic burden on the healthcare system of FBiH through increased prevalence and management of chronic diseases. The estimated annual burden of €121 million highlights obesity as an important public health and healthcare financing challenge. Investments in prevention and effective obesity management may reduce future healthcare expenditures and improve population health outcomes.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE178
Topic
Economic Evaluation, Epidemiology & Public Health, Health Policy & Regulatory
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity)