Medical Innovation and the Changing Health and Health Care Costs of Obesity

Between 1980 and 2010, the prevalence of obesity, defined as a body mass index (BMI) greater than or equal to 30, has more than doubled (15% to 36.1%) and the prevalence of extreme obesity, defined as a BMI greater than or equal to 40, has increased more than four-fold (1.4% to 6.6%) among American adults. The consequences of this trend on population health and healthcare services are well established. Obese people present a higher risk of contracting chronic conditions and heart disease than individuals within a normal BMI range, and annual per capita medical spending has been estimated to be 41.5% ($1,429) higher among the obese in 2006. However, the past 30 years have also seen the development of several medical innovations intended to mitigate adverse health consequences of obesity.  This paper aims to measure the impact of medical innovation on the health and health care costs of obesity, using statins as a case study. Statins have been shown to reduce the incidence of both fatal and non-fatal coronary heart disease events, as well as both fatal and non-fatal strokes among individuals not previously diagnosed with heart disease or stroke. Due to the relationship between obesity and hypercholesterolemia, statins play an important role in the medical management of obese individuals and the prevention of costly obesity-related sequela. Using well-recognized estimates of the health impact of statins and the Future Elderly Model (FEM) – an established dynamic microsimulation model of health of Americans aged over 50 –, we forecast the life trajectories and medical costs of elderly Americans in a scenario in which statins have not been discovered. By comparing the marginal cost of being obese in this scenario and the baseline version of the FEM, we estimate the change in the health and health care cost of obesity due to the introduction and widespread use of statins. We focus on health outcomes such as life expectancy and disability, health care costs including total spending and spending by public programs, and economic consequences such as impacts on earnings, taxes and disability insurance.