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Healthcare Costs Associated with Change in Body Mass Index in Patients with Type 2 Diabetes Mellitus in Spain

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  • Tatiana Dilla
  • Amparo Valladares
  • Claudia Nicolay
  • Javier Salvador
  • Jesús Reviriego
  • María Costi

Abstract

Background: Weight management is considered a key therapeutic strategy in type 2 diabetes mellitus. However, little is known about the impact of weight loss or body mass index (BMI) reduction on type 2 diabetes-related healthcare costs. Objective: The aim of this study was to estimate the economic impact of change in BMI among patients with type 2 diabetes mellitus from the Spanish healthcare system perspective. Methods: The ECOBIM study is an observational, non-interventional study in which data on BMI change and costs incurred by patients with type 2 diabetes were collected cross-sectionally and retrospectively for a 12-month period. Generalized linear mixed models were applied to estimate the effects of (i) BMI change in general (one-slope model); (ii) BMI gain and no BMI gain (two-slope model); and (iii) BMI gain and no BMI gain among obese and non-obese patients (four-slope model). Results: We studied 738 patients with a mean (SD) age of 66 (11) years and BMI of 30.6 (5.2) kg/m 2 . During the 12-month study period, 41.2% of patients gained BMI (BMI gainers) and 58.8% experienced either loss (52.2%) or no change (6.6%) in BMI (non-BMI gainers). One-unit gain (or loss) in BMI was significantly (p>0.001) associated with a 2.4% cost increase (or decrease) [one-slope model]. Every unit gain in BMI was associated with a 20.0% increase in costs among BMI gainers while losing one unit was associated with an 8.0% decrease in costs among non-BMI gainers (two-slope model, p>0.01). The economic benefit associated with reducing one BMI unit was 9.4% cost decrease in obese and 2.7% in non-obese patients (4-slope model). Conclusion: An increase in BMI among patients with type 2 diabetes was associated with increased 1-year direct healthcare costs. A reduction in BMI was associated with appreciable short-term economic benefits, especially in obese patients. Copyright Springer International Publishing AG 2012

Suggested Citation

  • Tatiana Dilla & Amparo Valladares & Claudia Nicolay & Javier Salvador & Jesús Reviriego & María Costi, 2012. "Healthcare Costs Associated with Change in Body Mass Index in Patients with Type 2 Diabetes Mellitus in Spain," Applied Health Economics and Health Policy, Springer, vol. 10(6), pages 417-430, November.
    • Handle: RePEc:spr:aphecp:v:10:y:2012:i:6:p:417-430
    DOI: 10.1007/BF03261876
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    References listed on IDEAS

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    1. Anirban Basu & Willard G. Manning & John Mullahy, 2004. "Comparing alternative models: log vs Cox proportional hazard?," Health Economics, John Wiley & Sons, Ltd., vol. 13(8), pages 749-765, August.
    2. Miguel Ballesta & Florentino Carral & Gabriel Olveira & José Girón & Manuel Aguilar, 2006. "Economic cost associated with type II diabetes in Spanish patients," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 7(4), pages 270-275, December.
    3. Oster, G. & Thompson, D. & Edelsberg, J. & Bird, A.P. & Colditz, G.A., 1999. "Lifetime health and economic benefits of weight loss among obese persons," American Journal of Public Health, American Public Health Association, vol. 89(10), pages 1536-1542.
    4. Molina, Begoña & Monereo, Susana, 2003. "Direct healthcare costs of diabetes mellitus patients in Spain," UC3M Working papers. Economics we036827, Universidad Carlos III de Madrid. Departamento de Economía.
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