Costs of treating serious adverse effects of drugs used for treatment of obesity: comparison of selected European countries

Drugs for the treatment of obesity show significant effectiveness, but the adverse effects (ADRs) of these drugs are numerous and varied, and some of them are highly cost-generating. Our research aimed to define the health care utilization pattern in treating ADRs of antiobesity therapy, to compare the costs of treating these ADRs among selected European countries, and to identify the key cost drivers. A comparative analysis of the costs of treating the ADRs of antiobesity drugs in 10 European countries (seven EU members and three from the Western Balkans) was conducted, and the impact of parameters of global health expenditures on them was assessed. There are considerable differences in costs of treating adverse antiobesity drug reactions among European countries: costs of treating gastroesophageal reflux disease varied almost 20 times between North Macedonia (12.6 EUR) and Estonia (202.9 EUR). The Gross Domestic Product per capita was an important cost driver in treating the majority of the ADRs studied (<i>p</i> &lt; .001), except for retinopathy, anaphylaxis, and respiratory disorders. The Domestic Private Health Expenditure increased the costs of treating depression (<i>p</i> = .012), upper respiratory tract infection (<i>p</i> = .008), melanocytic naevus (<i>p</i> = .027), and drug-induced hepatitis (<i>p</i> = .023). Investment in pharmaceuticals, medical goods, and preventive care tended to reduce the costs of treating several ADRs, which are seemingly unrelated to the body site or mechanism. Healthcare utilization and costs of treating ADRs to antiobesity drugs vary significantly among European countries. These differences should be considered when creating inputs for cost-effectiveness and budget impact models to decrease their uncertainty.

用于治疗肥胖的药物展现出显著疗效，但此类药物的不良反应（ADRs，Adverse Drug Reactions）数量繁多且类型多样，部分不良反应还会带来高昂的医疗成本。本研究旨在明确抗肥胖治疗相关不良反应的医疗服务利用模式，对比部分欧洲国家治疗此类不良反应的成本，并识别关键的成本驱动因素。
本研究针对10个欧洲国家（7个欧盟成员国与3个西巴尔干国家）开展抗肥胖药物不良反应治疗成本的比较分析，并评估全球卫生支出相关参数对该成本的影响。
欧洲各国在抗肥胖药物不良反应的治疗成本上存在显著差异：以胃食管反流病的治疗成本为例，北马其顿（12.6欧元）与爱沙尼亚（202.9欧元）之间的差距接近20倍。
人均国内生产总值是影响绝大多数研究不良反应治疗成本的重要因素（p < 0.001），但视网膜病变、过敏性休克与呼吸系统疾病除外。国内私人卫生支出会提升抑郁症（p = 0.012）、上呼吸道感染（p = 0.008）、黑素细胞痣（p = 0.027）以及药物性肝炎（p = 0.023）的治疗成本。医药、医用物资与预防保健领域的投入则倾向于降低多种与受累部位或发病机制看似无关的不良反应的治疗成本。
欧洲各国抗肥胖药物不良反应的医疗服务利用情况与治疗成本存在显著差异。在构建成本效益与预算影响模型的输入参数时，应考虑到这些差异，以降低模型的不确定性。