Estimating the healthcare cost of overweight and obesity in South Africa

Micheal Kofi Boachie; Evelyn Thsehla; Mustapha Immurana; Ciaran Kohli-Lynch; Karen J Hofman

doi:10.1080/16549716.2022.2045092

Estimating the healthcare cost of overweight and obesity in South Africa

Glob Health Action. 2022 Dec 31;15(1):2045092. doi: 10.1080/16549716.2022.2045092.

Authors

Micheal Kofi Boachie¹, Evelyn Thsehla¹, Mustapha Immurana², Ciaran Kohli-Lynch^{1

3}, Karen J Hofman¹

Affiliations

¹ SAMRC/Wits Centre for Health Economics and Decision Science - PRICELESS SA, Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
² Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana.
³ Center for Health Services and Outcomes Research, Northwestern University, Chicago, Illinois, USA.

Abstract

Background: Overweight and obesity are major risk factors for noncommunicable diseases. This presents a major burden to health systems and to society in South Africa. Collectively, these conditions are overwhelming public healthcare. This is happening when the country has embarked on a journey to universal health coverage, hence the need to estimate the cost of overweight and obesity.

Objective: Our objective was to estimate the healthcare cost associated with treatment of weight-related conditions from the perspective of the South African public sector payer.

Methods: Using a bottom-up gross costing approach, this study draws data from multiple sources to estimate the direct healthcare cost of overweight and obesity in South Africa. Population Attributable Fractions (PAF) were calculated and multiplied by each disease's total treatment cost to apportion costs to overweight and obesity. Annual costs were estimated for 2020.

Results: The total cost of overweight and obesity is estimated to be ZAR33,194 million in 2020. This represents 15.38% of government health expenditure and is equivalent to 0.67% of GDP. Annual per person cost of overweight and obesity is ZAR2,769. The overweight and obesity cost is disaggregated as follows: cancers (ZAR352 million), cardiovascular diseases (ZAR8,874 million), diabetes (ZAR19,861 million), musculoskeletal disorders (ZAR3,353 million), respiratory diseases (ZAR360 million) and digestive diseases (ZAR395 million). Sensitivity analyses show that the total overweight and obesity cost is between ZAR30,369 million and ZAR36,207 million.

Conclusion: This analysis has demonstrated that overweight and obesity impose a huge financial burden on the public health care system in South Africa. It suggests an urgent need for preventive, population-level interventions to reduce overweight and obesity rates. The reduction will lower the incidence, prevalence, and healthcare spending on noncommunicable diseases.

Keywords: Cost; South Africa; attributable fraction; noncommunicable diseases; obesity; overweight; priority setting.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cost of Illness
Health Care Costs
Humans
Noncommunicable Diseases*
Obesity / epidemiology
Overweight* / epidemiology
South Africa / epidemiology

Grants and funding

This study received funding from Bloomberg Philanthropies through the University of North Carolina, USA [grant number 5106249] and the South African Medical Research Council [grant number 23108].