ArticleBMJ open2019
To what extent does sex, age and BMI impact medical and pharmacy costs? A retrospective cohort study involving employees in a large school district in the USA.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.
- Costs of obesity, obesity-related complications, and weight loss in the United States: A systematic literature review.Journal of managed care & specialty pharmacy · 2025Pooled it
- Assessing the impact of pregnancy and birth factors on the maternal and infant microbiota.Microbiome research reports · 2023Article
- Prevalence and patterns of anti-osteoporotic drug use based on 2019 real-world nationwide data in Greece.Archives of osteoporosis · 2022Article
- Prostate-Specific Antigen Screening According to Health Professional Counseling and Age in the United States.Prostate cancer · 2022Article
- Victims of family violence identified in emergency care: Comparisons of mental health and somatic diagnoses with other victims of interpersonal violence by a retrospective chart review.Preventive medicine reports · 2020Article
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo identify the extent that sex, age and body mass index (BMI) is associated with medical and pharmacy costs.
designRetrospective cohort.
settingA school district in the Western USA involving 2531 workers continuously employed during 2011-2014.
main outcome measuresMedical and pharmacy costs and BMI.
resultsApproximately 84% of employees participated in wellness screening. Participants were 1.03 (95% CI 1.01 to 1.06) times more likely to be women and younger (M=47.8 vs 49.8, p<0.001). Median medical and pharmacy costs were higher for women than men, increased with age, and were greater in morbidly obese individuals (p<0.001). Annual pharmacy claims were 18% more likely to be filed by women than men, 23% more likely filed by those aged ≥60 versus <40 years, and 6% more likely filed by morbidly obese individuals than of normal weight (p<0.001) individuals. Greater medical and pharmacy costs in older age were most pronounced in underweight and morbidly obese groups. Higher use of medication among women than men was primarily because of drugs involving birth control, osteoporosis, thyroid disease and urinary tract infection. Higher medication use in older age was primarily related to medications used to treat gastrointestinal problems. Medication use was positively associated with BMI weight classifications for most of the 33 drug types considered, with exceptions involving birth control, herpes and osteoporosis. A J-shape relationship was observed between BMI and medication use for acne, antibiotic, cold/influenza/allergy, eye infection, oedema, muscle spasms, pain and ulcers.
conclusionsMedications associated with higher medical and pharmacy costs among women, older age and underweight or obese individuals are identified. Lowering medical and pharmacy costs requires weight management in older ages, particularly for underweight and obese. Higher pharmacy costs for certain drugs among underweight individuals may be associated with poorer nutrition.
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