In long-term US cancer survivors, obesity is associated with substantial excess medical spending

Abstract

A study published in Cancer has found substantial excess annual care utilisation and medical spending associated with obesity in long-term cancer survivors (≥2 years since diagnosis) in the USA using a nationally-representative sample. The researchers identified adult long-term cancer survivors (n = 12 547) from the 2008–2016 Medical Expenditure Panel Survey. They compared the excess care utilisation and spending associated with overweight (body mass index [BMI] 25–30 kg/m2), obesity (BMI ≥30 kg/m2), and severe obesity (BMI ≥40 kg/m2), compared with normal weight (BMI 18.5–25 kg/m2). Two-part modelling was used to calculate average annual care utilisation and spending by service type (office-based medical provider visits, hospital outpatient visits, hospital inpatient overnight stays, emergency room [ER] visits, home healthcare days, prescription medicines, and dental visits). Of the cancer survivors included in the study, 31.1% were obese (4.9% with severe obesity), 36.3% were overweight, and the remaining 32.6% were normal weight. Overweight cancer survivor healthcare utilisation and spending were similar to normal-weight cancer survivors; however, cancer survivors with obesity had an additional $US3216 of medical spending – $1243 on hospital inpatient services and $1130 on prescriptions per patient per year. In the USA in 2016, the excess annual medical spending associated with obesity in long-term cancer survivors was $19.7 billion; this excess medical spending was higher in cancer survivors with severe obesity ($5317 per patient per year, or $6.7 billion in 2016). The excess in healthcare utilisation and medical spending were mostly accounted for by obesity-related comorbidity.