What is the clinical evidence from this study?

Study design: Cohort. Population: Obstructive sleep apnea in overweight to severely obese adults (n=27942). Intervention: Obstructive sleep apnea (OSA) vs. Non-OSA controls. Primary outcome: Total healthcare costs (Adjusted cost ratio 1.24, 95% CI 1.20-1.28).

What question did this study set out to answer?

This study aims to measure the economic impact and healthcare utilization of obstructive sleep apnea (OSA) among overweight to obese patients.

June 10, 2026

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

Key Result

Comorbid obstructive sleep apnea in overweight to severely obese adults was associated with higher total healthcare costs compared to controls (adjusted cost ratio 1.24; 95% CI 1.20-1.28).

Key Points

This study aims to measure the economic impact and healthcare utilization of obstructive sleep apnea (OSA) among overweight to obese patients.
Utilized IQVIA PharMetrics Plus claims data from 2016 to 2025 to analyze healthcare costs.
Conducted propensity-score matching of OSA patients to non-OSA controls in a cohort of 27,942 adults.
Applied generalized linear models to assess adjusted cost ratios and average marginal effects over 365 days.
Patients with OSA had significantly higher total healthcare costs (adjusted cost ratio = 1.24; 95% CI = [1.20, 1.28]), with an average marginal effect of $6942 per patient.
Costs were largely driven by outpatient visits (AME = $2955) and prescription expenses (AME = $3198).
Incremental costs were especially high in patients with cardiovascular disease (AME = $9257) and remained substantial among chronic GLP-1 RA users (AME = $12359).

Study Design

Type

Cohort (n=27,942)

Structured PICO

Does comorbid obstructive sleep apnea increase healthcare costs and utilization in overweight to severely obese adults?

Population

27,942 overweight to severely obese adults aged 18-64 years (13,971 with diagnosed OSA propensity-score matched 1:1 to 13,971 non-OSA controls) identified from commercial claims data.

Intervention

Comorbid obstructive sleep apnea (OSA)

Comparator

Propensity-score matched non-OSA controls

Outcome

Incremental economic and utilization burden (adjusted cost/rate ratios and average marginal effects) over a 365-day follow up period

Comorbid OSA in overweight to obese adults significantly increases healthcare costs, driven by outpatient and prescription expenses, with an even higher burden in patients with CVD or on GLP-1 RAs.

Main Result

Effect estimate: Adjusted cost ratio 1.24 (95% CI 1.20-1.28)

Abstract

ABSTRACT 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.

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