OBJECTIVES: Obesity is a progressive chronic disease associated with many serious complications. Objectives of this study were to assess the incidence proportion (IP) and period prevalence (PP), and quantify complication-specific costs in the 1-year following diagnosis, for 13 obesity-related complications (ORCs) by BMI class.

METHODS: Adult patients (≥18 years) with ≥1 recorded BMI value were identified using linked US data from IQVIA’s Ambulatory Electronic Medical Records and Real-World Data Adjudicated Claims – US Database. ORCs were identified using ICD-9/10 diagnosis codes. IP and PP for ORCs were assessed in each calendar year from 2010-2017. Incidence was defined based on absence of ORC diagnosis codes in the prior calendar year. For the cost assessment, the first date of an ORC diagnosis from 1/2010-12/2016 defined the index date. Patients with continuous enrollment 1-year-pre-index (without ORC diagnosis) and 1-year-post-index and ≥1 recorded BMI value in the 6-month-pre-index were included. Complication-specific cost over the 1-year-post-index (reported in 2017 USD) included claims with a diagnosis code for the specific ORC (primary position for hospitalizations) and ORC-specific medications and procedures. Underweight patients (BMI<18.5 kg/m²) were excluded. Descriptive analyses were conducted for complications overall and by BMI class.

RESULTS: The two most common ORCs based on IP and PP were musculoskeletal pain (overall range across years IP: 17.8-19.9%, PP: 28.3-32.6%) and hypertension (IP: 5.7-6.8%, PP: 26.8-29.5%). IP and PP increased by BMI class for most ORCs. Most costly ORCs based on mean total 1-year cost were osteoarthritis of the knee ($3,697 [range from normal weight (BMI:18.5-24.9 kg/m²) to class III obesity (BMI:≥40 kg/m²): $2,453 - $4,518]), heart failure with preserved ejection fraction ($3,586 [$3,402 - $4,685]), obstructive sleep apnea ($2,768 [$2,442 - $2,974]) and psoriasis ($2,711 [$2,131 - $3,292]).

CONCLUSIONS: ORCs are important drivers of the economic burden of obesity. Appropriate management of obesity may reduce ORC-associated costs.