OBJECTIVES: To provide an assessment of the economic burden of obesity across a comprehensive spectrum of obesity-related comorbidities (ORCs) for four countries within the South-East Europe (SEE) region (Czech Republic, Greece, Hungary, and Romania) where obesity rates have surged past 20%.

METHODS: A micro-costing approach from the public payer’s perspective was used to estimate direct healthcare costs associated with 10 ORCs in 4 SEE countries. In each country, experienced clinicians were asked to estimate healthcare resource use (HCRU) associated with each ORC, while hospital administrators were asked to estimate healthcare unit costs. The overall annual cost per patient per ORC was estimated by summing all cost items within each ORC cost category.

RESULTS: Chronic kidney disease (CKD) and cardiovascular diseases (CVD) were generally the costliest ORCs across all 4 countries, where annual cost burden per ORC exceeded 1500 USD per patient per year. Individuals with any single ORC incurred direct healthcare costs ranging from 979 – 3,684 USD in Hungary to 1,540 – 16,258 USD in Greece annually. Hypertension, asthma, and hyperlipidemia were the least costly ORCs, incurring approximately one-tenth to one-third of the costs of the costliest complications.

CONCLUSIONS: To our knowledge, this is the first study in respective countries that comprehensively evaluate costs and HCRU associated with managing ORCs at an average individual patient level. Our findings address an evidence gap, and further confirm that the high prevalence of obesity and its complications result in significant financial burden, while immense cost savings can be achieved by preventing or delaying the occurrence of obesity. By quantifying the burden of obesity from a public healthcare perspective, our study aims to support policy efforts that promote health education and promotion in combating obesity.