TY - JOUR
T1 - The impact of obesity on health care costs among persons with schizophrenia
AU - Chwastiak, Lydia A.
AU - Rosenheck, Robert A.
AU - McEvoy, Joseph Patrick
AU - Stroup, T. Scott
AU - Swartz, Marvin S.
AU - Davis, Sonia M.
AU - Lieberman, Jeffrey A.
N1 - Funding Information:
This article was based on results from the CATIE project, supported by the NIMH (NO1 MH90001). The aim of this project was to examine the comparative effectiveness of antipsychotic drugs in conditions for which their use is clinically indicated, including schizophrenia and Alzheimer's disease. The project was carried out by principal investigators from the University of North Carolina, Duke University, the University of Southern California, the University of Rochester and Yale University in association with Quintiles, Inc.; the program staff of the Division of Interventions and Services Research of the NIMH; and investigators from 56 sites in the United States (CATIE Study Investigators Group). AstraZeneca Pharmaceuticals LP; Bristol-Myers Squibb Company; Forest Pharmaceuticals, Inc.; Janssen Pharmaceutica Products, L.P.; Eli Lilly and Company; Otsuka Pharmaceutical Co., Ltd.; Pfizer Inc.; and Zenith Goldline Pharmaceuticals, Inc., provided medications for the studies. The Foundation of Hope of Raleigh, NC, also supported this work.
PY - 2009/1
Y1 - 2009/1
N2 - Background: Obesity is the second leading cause of preventable death in the United States and is twice as common among individuals with schizophrenia as the general population. Methods: Data from the Clinical Antipsychotic Trials of Intervention Effectiveness, a multisite trial of antipsychotic pharmacotherapy in 1460 patients with schizophrenia, were used to examine the relationships between body mass index (BMI) and medical costs. Results: ANCOVA analyses found significant increases in both psychiatric and nonpsychiatric medication costs associated with increasing BMI and a significant, but smaller, difference in costs of outpatient medical-surgical service utilization: US$41 per month for morbidly obese patients compared to US$26 per month for patients of normal weight (F=2.4, P=.04). In multivariable logistic regression analyses, morbid obesity was associated with significantly increased odds of any outpatient medical-surgical service costs. When compared to observations of BMI>35, BMI observations within the normal range (18.5-24.9) were half as likely to be associated with any outpatient medical-surgical costs (OR=0.53; 95% CI=0.45, 0.63). Conclusions: In this large sample of persons with schizophrenia, obesity was associated with increased outpatient general medical service and medication costs even after controlling for demographic characteristics and medical comorbidity, but the absolute dollar amount was small.
AB - Background: Obesity is the second leading cause of preventable death in the United States and is twice as common among individuals with schizophrenia as the general population. Methods: Data from the Clinical Antipsychotic Trials of Intervention Effectiveness, a multisite trial of antipsychotic pharmacotherapy in 1460 patients with schizophrenia, were used to examine the relationships between body mass index (BMI) and medical costs. Results: ANCOVA analyses found significant increases in both psychiatric and nonpsychiatric medication costs associated with increasing BMI and a significant, but smaller, difference in costs of outpatient medical-surgical service utilization: US$41 per month for morbidly obese patients compared to US$26 per month for patients of normal weight (F=2.4, P=.04). In multivariable logistic regression analyses, morbid obesity was associated with significantly increased odds of any outpatient medical-surgical service costs. When compared to observations of BMI>35, BMI observations within the normal range (18.5-24.9) were half as likely to be associated with any outpatient medical-surgical costs (OR=0.53; 95% CI=0.45, 0.63). Conclusions: In this large sample of persons with schizophrenia, obesity was associated with increased outpatient general medical service and medication costs even after controlling for demographic characteristics and medical comorbidity, but the absolute dollar amount was small.
KW - Cost
KW - Obesity
KW - Schizophrenia
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U2 - 10.1016/j.genhosppsych.2008.09.012
DO - 10.1016/j.genhosppsych.2008.09.012
M3 - Article
C2 - 19134502
AN - SCOPUS:58149197909
SN - 0163-8343
VL - 31
SP - 1
EP - 7
JO - General Hospital Psychiatry
JF - General Hospital Psychiatry
IS - 1
ER -