Excess Costs and Economic Burden of Obesity-Related Cancers in the United States

• Published in: Value in health 2019-12, Vol.22 (12), p.1378-1386
• Main Authors: Hong, Young-Rock, Huo, Jinhai, Desai, Raj, Cardel, Michelle, Deshmukh, Ashish A.
• Format: Article
• Language: English
• Subjects: Body mass index; Breast cancer; Cancer; cancer burden in the United States; economic burden of cancer; excess costs of cancer care; Geriatrics; Health care; Health care expenditures; Obesity; obesity-related cancer; Older people; Prevention programs; Risk factors; Sociodemographics; Survivor
• ISSN: 1098-3015; 1524-4733
• DOI: 10.1016/j.jval.2019.07.004

Obesity is a significant risk factor of several cancers that imposes a substantial economic burden on US healthcare that remains to be quantified. We estimated the excess costs and economic burden of obesity-related cancers in the United States. From the Medical Expenditure Panel Survey (2008-2015) data, we identified 19 405 cancer survivors and 175 498 non-cancer individuals. We estimated annual health expenditures using generalized linear regression with log link and gamma distribution by cancer types (stratified by 11 obesity-related cancers and other cancer types), controlling for sociodemographic and clinical characteristics. All cost estimates were adjusted to 2015 USD value. The average annual total health expenditures were $21 503 (95% CI, $20 946-$22 061) for those with obesity-related cancer and $13 120 (95% CI, $12 920-$13 319) for those with other cancer types. There was a positive association between body mass index and health expenditures among cancer survivors: for each additional 5-unit increase in body mass index, the average predicted expenditures increase by $1503 among those with obesity-related cancer and by $722 among those with other cancers. With adjustments for sociodemographic and clinical characteristics, the mean incremental expenditures of treating obesity-related cancer were 2.1 times higher than those of other cancers ($4492 vs $2139) and more considerable among the non-elderly cancer population. Obesity-related cancers accounted for nearly 43.5% of total direct cancer care expenditures, estimated at $35.9 billion in 2015. The economic burden of obesity-related cancer in the United States is substantial. Our findings suggest a need for the inclusion of comprehensive obesity prevention and treatment in cancer care. •The prevalence of obesity is greater among cancer patients, and the economic burden of obesity-related cancers has not been collectively quantified.•In this nationally representative sample of cancer patients, those with obesity-associated cancer incurred a higher mean annual total health expenditure ($21 503) than those with another cancer type ($13 120).•The mean incremental expenditures of treating patients with obesity-related cancers were approximately 2.1 times higher.•Obesity-related cancer accounted for nearly 43.5% of total direct cancer care expenditures, estimated at $35.9 billion in 2015.