Investigating the Incremental Cost and Utilization Burden of Obstructive Sleep Apnea in Overweight to Severely Obese Patients.

AIMS: To quantify the incremental economic and utilization burden of comorbid obstructive sleep apnea (OSA) within an overweight to severely obese adult population.

MATERIAL AND

METHODS

This retrospective cohort study utilized 2016-2025 IQVIA PharMetrics Plus Closed Health Plan commercial claims data to identify overweight to severely obese adults aged 18-64 years. Patients with diagnosed OSA were propensity-score matched 1:1 to non-OSA controls. Generalized linear models were constructed to quantify the incremental burden of OSA through adjusted cost/rate ratios and average marginal effects (AMEs) over a 365-day follow up period. Outcomes were also stratified by obesity severity, cardiovascular disease (CVD), diabetes, sex, and baseline glucagon-like peptide-1 receptor agonist (GLP-1 RA) use.

RESULTS

Among OSA patients, 13 971 (99.9%) were successfully matched (total n = 27 942). Patients with OSA incurred significantly higher total healthcare costs compared to controls (adjusted cost ratio = 1.24; 95% CI = [1.20, 1.28]), corresponding to an AME of $6942 per patient. Costs were driven by routine disease management such as outpatient visits (AME = $2955) and prescription costs (AME = $3198). Subgroup analyses revealed that incremental costs were high among patients with CVD (AME = $9257) and notably, the incremental cost of OSA remained substantial even among chronic users of GLP-1 RAs (AME = $12359).

CONCLUSION

Comorbid OSA is associated with a significant increase in total healthcare costs driven largely by outpatient and prescription costs. This burden was concentrated among patients with cardiovascular comorbidity and persisted among chronic GLP-1 RA users.