Ten-year cost-consequence analysis of weight loss on obesity-related outcomes in privately insured adults with obesity in Saudi Arabia.

AIM: This study aimed to estimate the 10-year cost-consequence of weight loss on obesity-related outcomes in a sample of privately insured adults with obesity in Saudi Arabia (KSA). METHODS: We analyzed data of adults with obesity (BMI ≥ 30 kg/m2) available in Nphies, the private health insurance platform of the Council of Health Insurance, KSA. A micro-costing analysis was used to obtain domestic cost estimates for obesity-related outcomes. Cox proportional hazard models were used to estimate the benefit of weight loss by preventing incident cases of 10 obesity-related outcomes. RESULTS: In the study cohort (n = 314,079), the 30-34.9 BMI category contributed two-thirds of the cohort, and no gender differences were found in the age distribution of BMI categories. The elderly population had a higher prevalence of obesity-related outcomes, such as hypertension, osteoarthritis, and type 2 diabetes mellitus (T2DM). The baseline cost (2023) for treating these outcomes was USD 1.245 billion, which could double in 10 years. A 15% weight loss could save USD 1.295 billion over 10 years, with most savings due to T2DM (USD 430 million), given its higher prevalence (27.5%). The model was most sensitive to cost variability in T2DM, dyslipidemia, and hypertension. LIMITATIONS: The results should be interpreted within the bounds of the study cohort, and Nphies is in its early stages of implementation. The cost estimates may differ if repeated among adults with obesity only, potentially leading to increased cost savings with weight loss. CONCLUSIONS: Moderate weight loss of 5-15% over 10 years is associated with substantial cost savings in Saudi Arabia. For a 15% weight loss, 18.8% of incidence cases of obesity-related outcomes may be prevented, and slowed increases in T2DM, dyslipidemia, and hypertension may lead to considerable cost savings. The findings would help policymakers to implement weight loss programs in KSA.

The yield of thyroid fine-needle aspiration in a primary care setting in Riyadh, Saudi Arabia.

Background: Thyroid cancer is the second most common cancer among women. This study was conducted to assess the yield of fine-needle aspiration (FNA) cytology of thyroid nodules in a primary care setting in Riyadh, Saudi Arabia. Materials and Methods: In this retrospective cohort study, primary care patients of both genders with thyroid nodules who underwent FNA above the age of 18 years were enrolled. Patients with a prior history of cancer were excluded. The data was collected from the histopathology reports of FNAs done for thyroid nodules from January 01, 2002 to July 31, 2018. Results: We enrolled 263 patients in this study. The mean age of the study population was 41.3 years old (Standard deviation (SD) ± 10.1), 81.7% were females and 18.3% were males. The rate of abnormal ultrasound (US) was 16%. The mean thyroid-stimulating hormone (TSH) level was 2.3 mU/L (SD ± 5.9). Post-thyroidectomy, 17.5% had carcinoma on pathology reports. Among those who were diagnosed with thyroid cancer, 76.2% had papillary thyroid cancer, 21.4% had follicular thyroid cancer, and 2.4% had medullary thyroid cancer. The mean age for cancer diagnosis was 40 years old (SD ± 8). There was no significant association between FNA findings (benign/malignant) and age, gender, history of smoking, size of the nodule, or TSH level. Conclusion: Thorough investigations including FNA should be considered for patients presenting with suspicious thyroid nodules, regardless of their size or the patients' gender. Access to such investigations and referrals to specialists should be available for primary care physicians.