Assessing the Economics ofObesity and Obesity Interventions                                                           Mich...
Exhibit 1 –            The Rise in Obesity in the U.S. 1961-2008                       (ages 20 and older)100%90%         ...
Exhibit 2 – Projections of Obesity Under Optimistic and Pessimistic Scenarios55%                US female - Pessimistic50%...
Exhibit 3 – Percentage Overweight in the                           US, England, Canada and France                        8...
Exhibit 4 –   Increased Spending Associated with Being Obese:       Percentage Increase by Payer and Service              ...
Exhibit 5 –   Increased Spending Associated with Being Obese:          Dollar Increase by Payer and Service               ...
Exhibit 6 –   CBO Projected Prevalence of Obesity and Health Care  Spending per Adult in 2020 Under Alternative Scenarios1...
Exhibit 7 - Interactions Between                      Medicine and Economics                              Cost IncreasingC...
Exhibit 8 – Cost Per Quality-Adjusted Life-Year (QALY)Saved Of Interventions to Prevent or Reduce Obesity                 ...
Exhibit 8 – Cost Per Quality-Adjusted Life-Year (QALY)Saved Of Interventions to Prevent or Reduce Obesity                 ...
Exhibit 8 – Cost Per Quality-Adjusted Life-Year (QALY)  Saved Of Interventions to Prevent or Reduce Obesity               ...
Exhibit 8 – Cost Per Quality-Adjusted Life-Year (QALY)  Saved Of Interventions to Prevent or Reduce Obesity               ...
Upcoming SlideShare
Loading in …5
×

Assessing the Economics of Obesity and Obesity Interventions by Michael J. O'Grady, PhD

404
-1

Published on

2012 Dialogue Presentation by Michael J. O'Grady, PhD

Published in: Health & Medicine
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
404
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
0
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Assessing the Economics of Obesity and Obesity Interventions by Michael J. O'Grady, PhD

  1. 1. Assessing the Economics ofObesity and Obesity Interventions Michael J. O’Grady, PhD President, West Health Policy Center CONFIDENTIAL – Do not reproduce or distribute
  2. 2. Exhibit 1 – The Rise in Obesity in the U.S. 1961-2008 (ages 20 and older)100%90% Extremely Obese80% Obese70% Overweight 5.1% 6.2% 6.0% 5.0% 5.4%60% 3.0%50% 0.9% 1.3% 1.4% 30.9% 31.3% 32.9% 35.1% 34.3% 23.2%40% 13.4% 14.5% 15.0%30%20% 31.5% 32.3% 32.1% 32.7% 33.6% 34.4% 33.4% 32.2% 33.6%10% 0% 1961 1972 1978 1990 2000 2002 2004 2006 2008Source: http://www.cdc.gov/NCHS/data/hestat/obesity_adult_07_08/obesity_adult_07_08.pdf 2 CONFIDENTIAL – Do not reproduce or distribute
  3. 3. Exhibit 2 – Projections of Obesity Under Optimistic and Pessimistic Scenarios55% US female - Pessimistic50% US female - Optimistic45% US male - Pessimistic40% US male - Optimistic35% Assumes U.S.30% women will maintain25% recent progress20%15% 1988 1992 1996 2000 2004 2008 2012 2016 2020 2024 2028 Source: Y. Claire Wang, Klim McPherson, Tim Marsh, Steven L Gortmaker, Martin Brown. “Health and economic burden of the projected obesity trends in the USA and the UK ,” Lancet, 2011; 378: 815–25. 1 3 CONFIDENTIAL – Do not reproduce or distribute
  4. 4. Exhibit 3 – Percentage Overweight in the US, England, Canada and France 80% Canada adjusted for underreporting 70%Proportion overweight 60% United States 50% 40% Canada England 30% France 20% 1970 1980 1990 2000 2010 2020 Source: http://www.oecd.org/document/57/0,3746,en_2649_33929_46038969_1_1_1_1,00.html. Canadian undercount - http://www.parl.gc.ca/Content/LOP/ResearchPublications/prb0511-. 1 4 CONFIDENTIAL – Do not reproduce or distribute
  5. 5. Exhibit 4 – Increased Spending Associated with Being Obese: Percentage Increase by Payer and Service (in 2008 dollars)30% Inpatient25% Non-inpatient Rx drugs20% Total 18.1% 17.1% 15.2% 15.2%15% 12.9% 11.9% 11.8% 10.3%10% 9.1% 8.5% 8.5% 9.1% 5.9% 5% n/s* n/s*n/s* 0% Medicare Medicaid Commercial Totaln/s = No statistically significant difference attributable to obesity.Source: Eric A. Finkelstein, Justin G. Trogdon, Joel W. Cohen, and William Dietz, “Annual Medical Spending Attributable toObesity: Payer and Service Specific Estimates.” Health Affairs 5 CONFIDENTIAL – Do not reproduce or distribute
  6. 6. Exhibit 5 – Increased Spending Associated with Being Obese: Dollar Increase by Payer and Service (in 2008 dollars)$160 $146.6$140 Inpatient Non-inpatient$120 Rx drugs$100 Total$80 $74.6 $69.3$60 $45.2 $44.7 $34.3 $31.5$40 $24.8 $27.6 $12.1 $18.3$20 $13.8 $5.1 $1.9 n/s*n/s* $0 Medicare Medicaid Commercial Totaln/s = No statistically significant difference in spending attributable to obesity.Source: Eric A. Finkelstein, Justin G. Trogdon, Joel W. Cohen, and William Dietz, “Annual Medical Spending Attributable toObesity: Payer and Service Specific Estimates.” He 6 CONFIDENTIAL – Do not reproduce or distribute
  7. 7. Exhibit 6 – CBO Projected Prevalence of Obesity and Health Care Spending per Adult in 2020 Under Alternative Scenarios100% Percentage of adults who are obese 90% Spending per adult percentage change, 2007–2020 80% 71% 70% 65% 59% 60% 50% 40% 37% 28% 30% 20% 20% 10% 0% Scenario 1: Scenario 2: Scenario 3: Distribution by Distribution by Body Weight Distribution of Body Weight Body Weight Remains Changes at the Average Annual Returns to the 1987 Distribution Unchanged from 2007 Rates for the 2001–2007 Period by 2020Source: Duchovny, N. and Baker, C., "How Does Obesity in Adults Affect Spending on Health Care?." Economic and BudgetIssue Brief, Congressional Budget Office, September 8, 2010. 7 CONFIDENTIAL – Do not reproduce or distribute
  8. 8. Exhibit 7 - Interactions Between Medicine and Economics Cost IncreasingClinically effective Clinically ineffective Cost Saving 8 CONFIDENTIAL – Do not reproduce or distribute
  9. 9. Exhibit 8 – Cost Per Quality-Adjusted Life-Year (QALY)Saved Of Interventions to Prevent or Reduce Obesity ESTIMATED COST PERINTERVENTION DESCRIPTION QALY SAVED REFERENCE SCHOOL-BASED INTERVENTIONCoordinated Approach Comprehensiveto Child Health intervention in $900 Brown et al. (2007)11(CATCH) elementary schoolsPlanet Health Comprehensive $4,305 for females; not Wang et al. (2003)13 intervention in middle effective for males schools COMMUNITY-BASED INTERVENTIONWheeling Walks Communitywide campaign using paid media to encourage $14,286 Reger-Nash (2004)16 walking among sedentary adultsStanford Five-City An integrated, Young (1996)18Project community-wide health education intervention $68,557 for improving physical activity. 9 CONFIDENTIAL – Do not reproduce or distribute
  10. 10. Exhibit 8 – Cost Per Quality-Adjusted Life-Year (QALY)Saved Of Interventions to Prevent or Reduce Obesity ESTIMATED COST PERINTERVENTION DESCRIPTION QALY SAVED REFERENCEWalking to meet health Training session involvingguidelines walking maps and Lombard $27,373 handouts on strategies and (1995)20 support maintaining a walking program.Environmental change Exposure to a more active lifestyle (bike paths, fitness $28,548 Linenger center, cycling, running). (1991)22Behavioral therapy; Use of personal trainers,personal trainers and behavior-therapy, financial $29,759 Jefferyincentives incentives, and calls to (1998)24 increase physical activityDiabetes Prevention Intensive program forProgram (DPP) adults at-risk of type 2 Knowler (2002)26 $46,914 diabetes. Exercise, diet 10 and behavior modification. CONFIDENTIAL – Do not reproduce or distribute
  11. 11. Exhibit 8 – Cost Per Quality-Adjusted Life-Year (QALY) Saved Of Interventions to Prevent or Reduce Obesity ESTIMATED COST PERINTERVENTION DESCRIPTION QALY SAVED REFERENCE PHARMACEUTICAL INTERVENTION Anti-obesity drug that inhibits absorption of, $8,327 Maetzel et alXenical (orlistat) and promotes excretion (2003)29 of, dietary fat. SURGICAL INTERVENTIONGastric bypass (older) Limits food intake by $5,000–$16,100 for women, Craig and reducing the effective $10,000–$35,600 for men Tseng (2002)33 size of the stomach and bypassing part of the small intestine.Gastric bypass (newer) Limits food intake by BMI – 40-50, Chang, et al. (2011)34 reducing the effective ORD $1,853, No ORD $3,770 size of the stomach and BMI – 50+, bypassing part of the ORD cost saving, No ORD small intestine $1,904 ORD – obesity-related disease. 11 CONFIDENTIAL – Do not reproduce or distribute
  12. 12. Exhibit 8 – Cost Per Quality-Adjusted Life-Year (QALY) Saved Of Interventions to Prevent or Reduce Obesity ESTIMATED COST PERINTERVENTION DESCRIPTION QALY SAVED REFERENCE WORKPLACE INTERVENTIONWorkplace Wellness Variety of interventions $3.27 drop in medical Baicker, Cutler, and SongPrograms (more recent) reviewed in a meta- expenses for every $1 (2010)38 analysis of evaluations spent on wellness programs done on employer- sponsored wellness plans; typical interventions include baseline health indicators, educational materials, and individual and group exercise.Workplace Wellness Emphasis on weight 26 percent reduction in Chapman (2005)39Programs (less recent) control and reduction of medical costs from chronic disease risk employer wellness factors. initiatives 12 CONFIDENTIAL – Do not reproduce or distribute

×