HEALTHCARE EXPENDITURES ASSOCIATED WITH BODY MASS INDEX IN ADULTS WITH TYPE 2 DIABETES AND ATHEROSCLEROTIC CARDIOVASCULAR DISEASE
Author(s)
Taiwo Adesoba, PhD1, Liana DesHarnais Bruce, MSPH, PhD2, Mriga Shrikhande, MS3.
1Principal Scientist, Timandi Life Sciences, South Brunswick, NJ, USA, 2Bruce Analytic Consulting Services LLC, Fuquay Varina, NC, USA, 3University of Arkansas for Medical Sciences, Little Rock, AR, USA.
1Principal Scientist, Timandi Life Sciences, South Brunswick, NJ, USA, 2Bruce Analytic Consulting Services LLC, Fuquay Varina, NC, USA, 3University of Arkansas for Medical Sciences, Little Rock, AR, USA.
OBJECTIVES: Type 2 diabetes (T2D) and atherosclerotic cardiovascular disease (ASCVD) are chronic conditions associated with substantial healthcare costs. While obesity is a known contributor to increased healthcare costs, contemporary estimates of incremental healthcare costs associated with elevated BMI among adults with comorbid T2D and ASCVD in the US are limited. Our study estimates the incremental annual healthcare expenditures associated with elevated BMI among adults with T2D and ASCVD in the US.
METHODS: This cross-sectional study used data from the 2022 Medical Expenditure Panel Survey (MEPS) and included adults aged ≥18 years diagnosed with T2D and ASCVD, identified using ICD-10 CM codes. BMI was categorized as normal/underweight (BMI<25) versus overweight/obese (BMI>=25). Descriptive statistics summarize demographic and clinical characteristics by BMI category. Generalized linear models (GLMs) and two-part models estimated adjusted differences in annual healthcare expenditures (total, inpatient, outpatient, office, emergency department, and pharmacy) with marginal effects used to estimate incremental expenditures associated with elevated BMI. Models were adjusted for ethnicity and poverty level, the only variables differing significantly between cohorts; expenditures were top-coded at the 99th percentile to limit outliers. Survey weights were applied to generate nationally representative estimates.
RESULTS: The final analytic sample included adults with T2D+ASCVD [unweighted(n)=276, weighted(n)=2,913,760] with an average age of 71 years; 84.8% were overweight/obese. Compared to the normal/underweight group, patients in the overweight/obese group were more likely to be non-Hispanic white (72.6% vs 58.7%, p=0.006) and less likely to be low-income (41.6% vs 61.3%, p=0.014). Unadjusted mean annual total healthcare expenditures were $24,021 (95% CI: $20,096, $27,947) in the overweight/obese group and $27,903 (95% CI: $20,490, $35,317) in the normal/underweight group. After adjustment, overweight/obesity was not significantly associated with a difference in healthcare expenditures (-$3208; 95%CI: -$12,835, $6420 for total expenditure).
CONCLUSIONS: In this BMI-dichotomized cohort of patients with T2D+ASCVD, no significant difference in healthcare costs was observed.
METHODS: This cross-sectional study used data from the 2022 Medical Expenditure Panel Survey (MEPS) and included adults aged ≥18 years diagnosed with T2D and ASCVD, identified using ICD-10 CM codes. BMI was categorized as normal/underweight (BMI<25) versus overweight/obese (BMI>=25). Descriptive statistics summarize demographic and clinical characteristics by BMI category. Generalized linear models (GLMs) and two-part models estimated adjusted differences in annual healthcare expenditures (total, inpatient, outpatient, office, emergency department, and pharmacy) with marginal effects used to estimate incremental expenditures associated with elevated BMI. Models were adjusted for ethnicity and poverty level, the only variables differing significantly between cohorts; expenditures were top-coded at the 99th percentile to limit outliers. Survey weights were applied to generate nationally representative estimates.
RESULTS: The final analytic sample included adults with T2D+ASCVD [unweighted(n)=276, weighted(n)=2,913,760] with an average age of 71 years; 84.8% were overweight/obese. Compared to the normal/underweight group, patients in the overweight/obese group were more likely to be non-Hispanic white (72.6% vs 58.7%, p=0.006) and less likely to be low-income (41.6% vs 61.3%, p=0.014). Unadjusted mean annual total healthcare expenditures were $24,021 (95% CI: $20,096, $27,947) in the overweight/obese group and $27,903 (95% CI: $20,490, $35,317) in the normal/underweight group. After adjustment, overweight/obesity was not significantly associated with a difference in healthcare expenditures (-$3208; 95%CI: -$12,835, $6420 for total expenditure).
CONCLUSIONS: In this BMI-dichotomized cohort of patients with T2D+ASCVD, no significant difference in healthcare costs was observed.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE637
Topic
Economic Evaluation, Epidemiology & Public Health
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Diabetes/Endocrine/Metabolic Disorders (including obesity)