Obesity: a major economic challenge for complementary healthcare?

Obesity: a major and growing public health problem


 

Obesity is defined by a body mass index (BMI[1]) of 30 or more, and has a significant impact on the health of those affected. Caused by a high-calorie diet, lack of physical activity and predisposing genetic factors, obesity is a major risk factor for many chronic diseases. Indeed, obesity leads to intermediate risk factors such as hypertension, dyslipidemia[2], insulin resistance and systemic inflammation, increasing the likelihood of serious pathologies such as cardiovascular disease, type 2 diabetes and certain cancers.

In France in 2020, 47.3% of adults were overweight (BMI over 25), including 17% of obese adults (compared with 38.3% and 10.1% respectively in 2000). The rising prevalence of obesity and the associated risks make it a major public health issue, and obesity is responsible for 6.6 million pathologies, treatments and episodes of care, and over 60,000 deaths every year.

 

A significant financial cost for the community and for complementary health insurance plans


 

In France, the total annual cost of obesity is estimated at 10.6 billion euros per year[3], or an average of 1,250 euros per affected individual. This amount encompasses a variety of expenses spread across several key players in the healthcare system and the economy. In fact, the cost of obesity is covered to the tune of 80% by health insurance, 12% by complementary health insurance and 8% by companies.

Obesity thus represents a cost of 1.3 billion euros each year for complementary health organizations, broken down as follows: 1.1 billion euros for outpatient care (medical consultations, drugs and paramedical care) and 0.2 billion euros for hospital care (surgical interventions and treatment of serious complications, for example).

This cost represents a significant proportion of the benefits paid out by complementary health organizations, reaching 32.8 billion euros[4] in 2020. The ratio of the cost of obesity to total benefits paid was thus 4.2%.

 

A key health and financial issue for complementary health insurance companies


 

The epidemiological data developed supra as well as the annual cost of obesity for complementary health insurance organizations, demonstrate the need to step up preventive measures in order to reverse the trend and reduce the prevalence of obesity.

Today, complementary healthcare organizations play an important role in financing prevention, covering 16%[5] of total prevention expenditure (all prevention schemes combined). However, despite the existence of numerous primary, secondary and tertiary prevention schemes, the strategies adopted are not sufficient to achieve the objective of reducing the prevalence of obesity, or even slowing its rate of increase.

 

Reinventing healthcare organizations' approaches to reverse the trend


 

In view of the urgency of the situation and the failure of previous prevention approaches, it is now time to develop these approaches, taking into account the constraints imposed on complementary health insurance organizations: limited access to health data, disincentive financial and institutional framework, accounting for management costs.

  • Strengthening secondary and tertiary prevention

 

To meet this challenge, complementary organizations need to focus on secondary and tertiary prevention (Assurance Maladie being the organization best placed to carry out massive primary prevention.) by reinforcing their existing offers, particularly in the context of group contracts, in a partnership approach with employers.

There are a number of possible courses of action within the traditional scope of complementary health insurance: increasing dietician packages, covering preventive medical examinations such as exercise stress tests, which can then be used to propose suitable exercise programs and monitor patients' progress, covering the cost of subscriptions to certified health applications, with access to data in return, so that monitoring and support can be tailored to individual needs, and providing in-company support, for example. via targeted collective actions, etc.

 
  • Acting on the nutrition value chain

 

There is another lever on which complementary health organizations could consider an innovative positioning: diversification along the nutrition value chain. Downstream of financial coverage, of course: through advice, coaching or participation in the healthcare system. This positioning already exists, but could be the subject of greater investment, particularly in individual support.

Even more innovative would be the involvement of complementary organizations upstream in the value chain, in the field of the agri-food industry or distributors. This would have several virtues: it would work at the root of the problems by attempting to transform the products consumed; it would help to improve individual health and thus reduce the long-term costs of obesity care; and it would use this field as an area for economic diversification.

In France, this diversification does not come naturally to the health insurance sector. And yet, it could prove to be a useful way of consolidating the insurance industry and promoting coherent, high-impact value chains for the French.

 

 
[1] Calculating body mass index or BMI (weight divided by height squared) indicates whether a person is overweight.
[2] Quantitative and qualitative abnormalities in lipid parameters such as total cholesterol
[3] ASTERES, March 2022
[4] DRESS, December 2023
[5] ASTERES, April 2022

Antoine Evennou, Director & Camille Dugelay Supervising Senior

Our health sector


 

Eurogroup Consulting supports all players in the industry health and social protection, central or within networks, in defining and implementing the changes needed to cope with changes in their ecosystem.

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