title: Impact of BMI and BMI change on future drug expenditures in adults: results from the MONICA/KORA cohort study.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Helmholtz Zentrum München - German Research Center for Environmental Health, Institute of Health Economics and Health Care Management, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany. christina.teuner@helmholtz-muenchen.de.
authors.forename: Christina M
authors.initials: CM
authors.lastname: Teuner
authors.forename: Petra
authors.initials: P
authors.lastname: Menn
authors.forename: Margit
authors.initials: M
authors.lastname: Heier
authors.forename: Rolf
authors.initials: R
authors.lastname: Holle
authors.forename: Jürgen
authors.initials: J
authors.lastname: John
authors.forename: Silke B
authors.initials: SB
authors.lastname: Wolfenstetter
mesh_terms: D015992:Body Mass Index; D015331:Cohort Studies; D016527:Drug Costs / Q000706:statistics & numerical data*; D004358:Drug Therapy / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D005102:Health Expenditures / Q000706:statistics & numerical data; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000188:drug therapy / Q000191:economics*; D009767:Obesity, Morbid / Q000188:drug therapy / Q000191:economics; D050177:Overweight / Q000188:drug therapy / Q000191:economics; D012959:Socioeconomic Factors