Pr. Gérard DURU Dr. Paul GARASSUS Présentation faite au Sénat, le 15 septembre 2010

Transcription

1 Pr. Gérard DURU Dr. Paul GARASSUS Présentation faite au Sénat, le 15 septembre 2010 French Health Economics Society (SFES)

2 Links between economy and obesity 1 - Overweight and obesity lead to the development of diseases such as diabetes (type 2), arterial hypertension, certain cancers, which have a direct impact on the wellbeing and life expectancy of the citizens. 2 - Overweight and obesity is one of the reasons for an increase in the national health expenditure 3 - Overweight and obesity have a negative effect on the evolution of the Gross Domestic Income. (absenteeism, loss of productivity) 4 - Overweight and obesity can threaten economically productive sectors such as the food industry and by interdependent effects all others sectors 5 - Overweight and obesity have a considerable social dimension : discrimination, loss of quality of live

3 HE4.3. Increasing obesity rates across the OECD Percentage of adult population with a Body Mass Index over 30 over time Source: OECD (2008), OECD Health Data 2008, CD-Rom, OECD, Paris ( Jap Swi Nor Ita Fra Swe Net Den Ice Aus Pol Bel Fin Spa Cze Slo Can Lux New Aus UK USA

4 Europe : Sweden 390 million (including 190 million Euros for hospitalization) 1,9 % of the total Health Expenditure Odegaard K, Borg S, Persson U, Svensson M., The Swedish cost burden of overweight and obesity-- evaluated with the PAR approach and a statistical modelling approach., Int J Pediatr Obes. 2008;3 Suppl 1:51-7 Canada : 6 billion Canadian $, 4.1% of the total health expenditure in Anis AH, Zhang W, Bansback N, Guh DP, Amarsi Z, Birmingham CL, Obesity and overweight in Canada: an updated cost-of-illness study., Obes Rev Apr 1 China : 2.74 billion dollars, 3.7% of total health expenditure in 2003 Zhao W, Zhai Y, Hu J, Wang J, Yang Z, Kong L, Chen C., Economic burden of obesity-related chronic diseases in Mainland China., Obes Rev Mar;9 Suppl 1:62-7

5 Indirect Costs loss of productivity of obese skilled workers (BMI > 35) : 1.18% higher than skilled workers with standard weight. This corresponds to a loss of productivity of $506 per worker with BMI > 35. Spoil DM, Succop P, Brehm BJ, Gillespie GL, Sommers data base, Obesity and presenteeism: the impact off body farmhouse index one workplace productivity., J Occup Approximately Med Jan; 50 (1): ,153 employees followed up from 1994 to 2003 of the company Shell. Obese employees had an absentee rate of 80% more than that of the normal weight group (24% versus 13.3%). Average loss of about 3.7 working days more than the employees with standard weight (7.2 days versus 3.6 days) Tsai SP, Ahmed FS, Wendt JK, Bhojani F, Donnelly RP., The impact off obesity one it absence and productivity in year industrial, Year Epidemiol Jan; 18 (1): 8-14.

6 BMI years years > 70 years 30 < BMI < BMI > Relative risk of mortality according to the BMI and the age Flegal KM, Graubard BI, Williamson D et coll. Excess deaths associated with underweight, overweight and obesity. JAMA, 2005; 293 (15): Quality of Life - Studies show deterioration in self esteem for the obese and derogatory looks by others. Even children less than 6 years perceive their obese peers as lazy, dirty, stupid, ugly, liars and frauds Wadden, T.A. and A.J. Stunkard, Social and psychological consequences of obesity. Annals of Internal Medecine, : p

7 BMI Male Female 20 50,71 62, ,98 66, ,25 70, ,52 75, ,79 79, ,06 83, ,84 89, ,62 94, ,4 100, ,18 105, ,96 111, ,23 116, ,5 121, ,77 126, ,04 131, ,31 135, ,58 140, ,85 145, ,12 150, ,39 155, ,66 160, Male Female Cost ( ) of the drugs according to the Body Mass Index Counterweight Project Team. Influence of body mass index on prescribing costs and potential cost savings of a weight management programme in primary care. J Health Serv Res Policy Jul;13(3):

8 Women Men Prevalence of the disease Relative Prevalence of the disease Relative Non Obese Obese increase Non Obese Obese increase Diabetes 1,15% 4,64% 303% 1,23% 6,60% 437% Asthma 9,29% 14,58% 57% 7,99% 6,66% -17% Hypertension 6,18% 22,14% 258% 9,76% 26,84% 175% Coronary arery disease 0,13% 0,68% 423% 0,50% 1,15% 130% Angina Pectoris 0,18% 0,46% 156% 0,28% 0,74% 164% Myocardial Infarction 0,22% 0,69% 214% 0,54% 1,06% 96% Other heart problems 3,26% 4,46% 37% 2,03% 2,75% 35% Cerebrovascular Accident 0,44% 0,62% 41% 0,15% 0,56% 273% Emphysema 0,10% 0,24% 140% 0,11% 0,20% 82% Joint pain 22,53% 35,57% 58% 24,93% 31,53% 26% Arthritis 8,07% 17,96% 123% 6,54% 12,60% 93%

9 Percentage of adult population with a Body Mass Index over 30 over time Difference females males OECD data

10 OECD data Percentage difference in obesity rates between 11 and 15 years by sex, Boys obesity rates - difference between 11 and 15 years R² = 0.52 IRL POL HUN CZE ESP ITA SVK GBR TUR PRT USA FIN Girls obesity rates - difference between 11 and 15 years LUX DEU CAN BEL DNK NLD FRA GRC ISL AUT SWE NOR CHE

11 US weight difference by gender and income (2004) Women and Men Low Income Women High Income healthy weight Overweight Low Income Obese High Income Men

12 Obesity weighs down U.S. economy with $147 billion in costs RTI study Jul. 27, 2009 The expanding waistlines in America are costing the economy as much as $147 billion a year in 2008 compared to $78.5 billion in 1998, according to RTI International researchers and two other organizations. Data from 1998 through 2006 shows that obesity in the U.S. increased by 37 percent, driving up related costs to 9.1 percent of medical expenditures, the researchers said. "As a result, the medical costs attributable to obesity are almost entirely a result of costs generated from treating the diseases that obesity promotes. Thus, obesity will continue to impose a significant burden on the health care system as long as the prevalence of obesity remains high. Eric Finkelstein, director of RTI's Public Health Economics Program

13 Health: Fat is a financial issue By Andrew Jack, Financial Times Published: September Obesity, once seen as a disease of decadence, is spreading fast in the poorer as well as the more industrialised world, sparking expressions of concern and a range of recent initiatives in China, India and the Middle East, as well as parts of Latin America which have among the highest rates anywhere. Worldwide, an estimated 1.6bn adults are now overweight, with 400m of them classifiable as obese With obesity rates rising in developed and developing nations alike, accompanied by declining productivity and rising morbidity, there is an immense medical demand for safe drugs to help stem the epidemic As for the counterintuitive finding that obesity is associated with only a modestly increased relative risk of mortality, Dr. Flegal

14 Economic consequences have to be measured Amid the economic downturn since 2008, there is some evidence that sales of cheap but unhealthy fast food have held up better than healthier alternatives Social consequences for healthcare costs but pensions as well Consumption and VAT A new economic model for a new population