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Pharmaceutical Costs in Obese Individuals
Comparison With a Randomly Selected Population Sample and Long-term Changes After Conventional and Surgical Treatment: The SOS Intervention Study
Kristina Narbro, PhD;
Göran Ågren, MD;
Egon Jonsson, PhD;
Ingmar Näslund, MD, PhD;
Lars Sjöström, MD, PhD;
Markku Peltonen, PhD
Arch Intern Med. 2002;162:2061-2069.
Background Obesity is associated with increased morbidity rates and pharmaceutical
costs. To what extent various medication costs are affected by intentional
weight loss is unknown.
Methods A cross-sectional comparison of the use of prescribed pharmaceuticals
was conducted in 1286 obese individuals in the Swedish Obese Subjects (SOS)
intervention study and 958 randomly selected reference individuals. Medication
changes for 6 years after bariatric surgery were evaluated in 510 surgically
and 455 conventionally treated SOS patients.
Results Compared with the reference group, obese individuals were more often
taking diabetes mellitus, cardiovascular disease, nonsteroidal anti-inflammatory
and pain, and asthma medications (risk ratios ranging from 2.3-9.2). Average
annual costs for all medications were 1400 Swedish kronor (SEK) (US $140)
in obese individuals and 800 SEK (US $80) in the reference population (P<.001). Average yearly medication costs during follow-up
were 1849 (US $185) in surgically treated patients (weight change -16%)
and 1905 SEK (US $190) in weight-stable conventionally treated patients (P = .87). The surgical group had lower costs for diabetes
mellitus (difference: -94 SEK/y (-US $9]) and cardiovascular disease
medications (difference: -186 SEK/y (-US $19]) but higher costs
for gastrointestinal tract disorder (difference: +135 SEK/y [US $13]) and
anemia and vitamin deficiency medications (difference: +50 SEK/y [US $5]).
Conclusions Use and cost of medications are markedly increased in obese vs reference
populations. Surgical obesity treatment lowers diabetes mellitus and cardiovascular
disease medication costs but increases other medication costs, resulting in
similar total costs for surgically and conventionally treated obese individuals
for 6 years.
From the Department of Medicine, Göteborg University, Sahlgrenska
University Hospital, Göteborg (Drs Narbro, Sjöström, and Peltonen),
the Department of Surgery, Örebro University Hospital, Örebro (Drs
Ågren and Näslund), and The Karolinska Institute and Department
of Medicine, Huddinge University Hospital, Stockholm (Dr Jonsson), Sweden.
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