Do Statins Reduce the Health and Health Care Costs of Obesity?
Do Statins Reduce the Health and Health Care Costs of Obesity?
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DOI：
10.1007/s40273-014-0234-y
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发表时间：
2015-07-01
影响因子：
4.4
通讯作者：
Sood, Neeraj
中科院分区：
文献类型：
--
作者：
Gaudette, Etienne;Goldman, Dana P.;Sood, Neeraj
肥胖既影响个人健康，鉴于其高患病率，也影响医疗保健支出总额。然而，随着医疗技术的发展，许多与肥胖有关的疾病的健康结果有所改善。本文以他汀类药物为例，探讨了医疗创新是否可以减轻与肥胖相关的不良健康和支出。由于肥胖与高胆固醇血症之间的关系，他汀类药物在肥胖个体的医疗管理和预防昂贵的肥胖相关后遗症方面发挥着重要作用。使用公认的他汀类药物对健康影响的估计和未来老年模型(FEM)-一个建立的50岁以上美国人健康的动态微观模拟模型-我们估计由于他汀类药物的引入和广泛使用而导致的预期寿命、功能状态和肥胖的医疗费用的变化。据估计，肥胖个体服用他汀类药物的预期寿命比体重正常的个体延长5- 6%，但这些额外的延长大多与某种程度的残疾有关。考虑到医疗支出和质量调整生命年的价值，他汀类药物并没有显著改变1类和2类肥胖的成本（体重指数[BMI]每千分之一日元30和每千分之一日元35 kg/m(2)），它们使3类肥胖的成本（BMI每千分之一日元40 kg/m(2)）增加1.2%。尽管他汀类药物对于降低肥胖相关疾病的风险非常有效，但它们并不能显著降低肥胖的成本。
Obesity impacts both individual health and, given its high prevalence, total health care spending. However, as medical technology evolves, health outcomes for a number of obesity-related illnesses improve. This article examines whether medical innovation can mitigate the adverse health and spending associated with obesity, using statins as a case study. Because of the relationship between obesity and hypercholesterolaemia, statins play an important role in the medical management of obese individuals and the prevention of costly obesity-related sequelae.Using well-recognized estimates of the health impact of statins and the Future Elderly Model (FEM)-an established dynamic microsimulation model of the health of Americans aged over 50 years-we estimate the changes in life expectancy, functional status and health care costs of obesity due to the introduction and widespread use of statins.Life expectancy gains of statins are estimated to be 5-6 % greater for obese individuals than for healthy-weight individuals, but most of these additional gains are associated with some level of disability. Considering both medical spending and the value of quality-adjusted life-years, statins do not significantly alter the costs of class 1 and 2 obesity (body mass index [BMI] a parts per thousand yen30 and a parts per thousand yen35 kg/m(2), respectively) and they increase the costs of class 3 obesity (BMI a parts per thousand yen40 kg/m(2)) by 1.2 %.Although statins are very effective medications for lowering the risk of obesity-associated illnesses, they do not significantly reduce the costs of obesity.