The metabolic syndrome is a constellation of risk factors (obesity, atherogenic dyslipidemia, raised blood pressure, insulin resistance) about which clinicians’ and health economists’ attention is growing. The present work is aimed at estimating the major medical costs directly related to the metabolic syndrome in Italy.
Materials and methods
The analysis is performed on an incremental basis, that is by comparing the amount of resources (drugs and hospitalisations for specific treatment) required by affected patients with the amount provided to the general population for similar (i.e. same ATC codes for drugs and same ICD-9 codes for admissions) resources. From the database of a large Local Health Unit in Northern Italy a general sample of 4974 patients was drawn, to whom an oral blood glucose lowering drug, a serum lipid reducing agent and an antihypertensive drug had been at least once prescribed during the observation period (years 2001 to 2003). An equal sized control group was selected in the remaining population records, matched by sex and age to the study group. Moreover, for particular purposes of deeper analysis, a “restricted” sample was defined as a subset (n = 1401) of the general one, where patients had received the above mentioned drugs at least once in each year of the observation period. As to the primary outcomes (demographic characteristics and basic average costs), the two kinds of samples (general and restricted) showed no considerable differences.
The metabolic syndrome affects males (49.5%) and females in the same proportion, while the mean age among the former sex group (64.6 years) is lower than among the latter (68.2 years). Yearly mortality among patients with metabolic syndrome (1.7%) does not differ from mortality in the general population. All costs in the study group were significantly higher than the corresponding in the control group. By the general sample, the total average cost per year for a patient with the metabolic syndrome was estimated at € 1,522 (drugs: € 558; hospitalisation: € 964), versus the lower analogous estimates in the general population: € 361 (total), € 155 (drugs), € 206 (hospitalisation). So, on a yearly and per capita basis, the (incremental) cost of the metabolic syndrome amounts to € 1,161. Mortality and age were shown to be particular cost drivers.
To the National Health Service in Italy, the cost for the metabolic syndrome might be as high as € 670 million a year (0.9% of the total public health expenditure).
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I peer reviewers, per questo articolo, sono stati coordinati da Andrea Messori.
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Lucioni, C., Mazzi, S., Cerra, C. et al. I costi della sindrome metabolica. Pharmacoeconomics-Ital-Res-Articles 7, 89–99 (2005). https://doi.org/10.1007/BF03320540