The Costs of Metabolic Syndrome in Italy

ISSN： 1120-9879

Source： High Blood Pressure & Cardiovascular Prevention, Vol.13, Iss.2, 2006-01, pp. : 53-60

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Abstract

Background: The metabolic syndrome is a combination of risk factors (obesity, atherogenic dyslipidaemia, raised blood pressure, insulin resistance) attracting the growing attention of clinicians and health economists. This study aimed to estimate the major medical costs directly related to the metabolic syndrome in Italy.Materials and methods: The analysis was performed on an incremental basis, by comparing the amount of resources (drugs and hospitalisation for specific treatment) required by affected patients with the amount provided to the general population for similar resources (i.e. same Anatomical Therapeutic Chemical Classification [ATC] codes for drugs and same International Classification of Diseases, 9th edition [ICD-9] codes for admissions). From the database of a large Local Health Authority (Azienda Sanitaria Locale) located 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 prescribed at least once during the observation period (years 2001-3). An equal sized control group was selected in the remaining population records, matched by sex and age to the study group. Moreover, for deeper analysis, a `restricted' sample was defined as a subset (n = 1401) of the general one, in which patients had received the above-mentioned drugs at least once in each year of the observation period. The two samples (general and restricted) showed no marked differences in the primary outcomes (demographic characteristics and basic average costs).Results: The metabolic syndrome affects males (49.5%) and females in the same proportion, while the mean age for males (64.6 years) is lower than for females (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 corresponding costs in the control group. For the general sample, the total average cost per year for a patient with the metabolic syndrome was estimated at euro1522 (drugs euro558; hospitalisation euro964), versus the lower analogous estimates in the general population: euro361 (total), euro155 (drugs) and euro206 (hospitalisation) [2003 values]. So on a yearly and per capita basis, the (incremental) cost of the metabolic syndrome amounts to euro1161. Mortality and age were shown to be particular cost drivers.Conclusions: To the National Health Service (Servizio Sanitario Nazionale) in Italy, the cost for the metabolic syndrome might be as high as euro670 million a year (0.9% of the total public health expenditure).