Impact of BMI and BMI change on future drug expenditures in adults: results from the MONICA/KORA cohort study

Background: The evidence on the long-term economic effects of
obesity is still scarce. This study aims to analyse the impact of
body mass index (BMI) and BMI-change on future pharmaceutical
utilisation and expenditures. Methods: Based on data from 2,946
participants in a German population-based health survey
(MONICA/KORA, 1994/95) and the follow-up study (2004/05), drug
intake and expenditures were estimated using a bottom-up approach.
Using univariate and multivariate methods, we analysed the impact
of baseline BMI and BMI-change on drug utilisation and expenditures
after 10 years. Results: The use of pharmaceuticals was more likely
in moderately and severely obese compared to the normal weight
group (OR 1.8 and 4.0, respectively). In those who reported
pharmaceutical intake, expenditures were about 40\% higher for the
obese groups. A 1-point BMI-gain in 10 years was, on average,
associated with almost 6\% higher expenditures compared to a
constant BMI. Conclusion: The results suggest that obesity as well
as BMI-gain are strong predictors of future drug utilisation and
associated expenditures in adults, and thus highlight the necessity
of timely and effective intervention and prevention programmes.
This study complements the existing literature and provides
important information on the relevance of obesity as a health
problem.