Obesidade nos cuidados de saúde primários em Portugal: uma análise de custos

Abstract

Background: Obesity has become an important individual and public health problem with elevated health, economic, and social costs. Its prevalence has increased substantially in the last 30 years, making it the XXI century epidemic. Clinical approaches have evolved to take into consideration the complexity of this pathology. However, in Portugal, the recommended treatment is still not accessible to all patients with obesity. Objective: With this study, we aimed to estimate the total cost of obesity in Portugal, as well as the cost of correctly treating obesity in the Portuguese primary care setting. Methods: For the estimate of obesity costs, we used published data on the additional number of primary care medical visits, costs with prescribed medication and medical exams and work absenteeism due to obesity. We estimated the cost for a primary health care visit from government reports. For the cost of treating obesity, we used published guidelines for the gold standard treatment and calculated the costs of necessary health care visits and pharmacological regimens. Results: We found that for each patient with obesity, there is an additional expense of 450.77€, per year compared to patients without obesity. Of this value, 160.40€ are due to work absenteeism and 290.37€ due to direct costs with health. We also estimate that 2.82% (595 million €) of the total Portuguese health expenditure (21 107.9 million €) are due to obesity. We found that the treatment of obesity in Portuguese primary care would cost, per patient, at least 549.90€ without medication and 1 079.10 € to 3 743.00 € when pharmacological treatment is needed, depending on the therapeutic option. Conclusions: We concluded that obesity is in fact an individual and public health problem, with important health, economic and social costs. The Portuguese health care system should work to implement the necessary measures to prevent and treat obesity, reaching the entire population and all the patients in need. This would allow for a cost reduction in future years, which is even more relevant in a time when healthcare sustainability is becoming more and more critical.