(377) Healthcare Costs and Resource Utilization in Medicaid-insured People with Overweight or Obesity and Knee Osteoarthritis in the United States: A Retrospective Database Study

Background: : Overweight or obesity increases the risk of onset and progression of knee osteoarthritis (OA-K). The American College of Rheumatology and Osteoarthritis Research Society International recommends weight reduction of ≥5% for people with OA-K. With continuous advancements in OA-K treatment and innovation in weight management, understanding the economic impact of OA-K in people with overweight or obesity is crucial.

Objective: : To describe healthcare costs and resource utilization in Medicaid-insured people with overweight or obesity and OA-K in the United States.

Methods: : This retrospective, observational study used Optum’s de-identified Market Clarity Data, linking medical and pharmacy claims with electronic health records. Adults (≥45 years) with ≥1 diagnosis code for OA-K (earliest as index date) between Oct 1, 2016 and Mar 31, 2023 (index period), baseline body mass index (BMI) ≥25 kg/m2 and classified as having moderate-to-severe OA-K pain based on previously validated real-world data algorithms were included. All participants had continuous medical and pharmacy Medicaid enrollment benefits, 12-month pre-index through ≥12-month post-index, after the earliest observed claim with OA-K diagnosis. Results were stratified by BMI categories: Overweight (≥25− < 30 kg/m2), Class 1 obesity (≥30− < 35 kg/m2), Class 2 obesity (≥35− < 40 kg/m2), and Class 3 obesity (≥40 kg/m2). All-cause and OA-K-related annualized healthcare costs were calculated post-index for different BMI categories and adjusted using a generalized linear model with gamma distribution (adjusted for age, sex, payor type, baseline Charlson Comorbidity index score, and baseline costs).

Results: : A total of 10,392 people with OA-K were included (Overweight: 26.2%; Class 1 obesity: 28.3%; Class 2 obesity: 20.1%; Class 3 obesity: 25.4%). The mean (SD) adjusted annualized all-cause total healthcare costs increased in the higher BMI categories: Overweight: $42,735 (44,565); Class 1 obesity: $44,803 (42,142); Class 2 obesity: $51,308 (46,385); Class 3 obesity: $57,555 (49,754). Similarly, mean (SD) OA-K-related total healthcare costs also increased in the higher BMI categories: Overweight: $3,430 (341); Class 1 obesity: $4,091 (393); Class 2 obesity: $4,701 (431); Class 3 obesity: $4,717 (428).

Conclusions: : This real-world study highlights the increasing economic impact of overweight or obesity in Medicaid-insured people with OA-K. Future studies evaluating the impact of weight management strategies focusing on OA-K-related healthcare costs should be undertaken.

Sponsorship:: Eli Lilly and Company.