Application of Mendelian Randomization to Investigate the Association of Body Mass Index with Health Care Costs

Christoph F. Kurz and Michael Laxy
Additional contact information
Christoph F. Kurz: Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, Neuherberg, Bayern, Germany
Michael Laxy: Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, Neuherberg, Bayern, Germany

Medical Decision Making, 2020, vol. 40, issue 2, 156-169

Abstract: Causal effect estimates for the association of obesity with health care costs can be biased by reversed causation and omitted variables. In this study, we use genetic variants as instrumental variables to overcome these limitations, a method that is often called Mendelian randomization (MR). We describe the assumptions, available methods, and potential pitfalls of using genetic information and how to address them. We estimate the effect of body mass index (BMI) on total health care costs using data from a German observational study and from published large-scale data. In a meta-analysis of several MR approaches, we find that models using genetic instruments identify additional annual costs of €280 for a 1-unit increase in BMI. This is more than 3 times higher than estimates from linear regression without instrumental variables (€75). We found little evidence of a nonlinear relationship between BMI and health care costs. Our results suggest that the use of genetic instruments can be a powerful tool for estimating causal effects in health economic evaluation that might be superior to other types of instruments where there is a strong association with a modifiable risk factor.

Keywords: bodymass index; health care costs; mendelian randomization; obesity (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

Downloads: (external link)
https://journals.sagepub.com/doi/10.1177/0272989X20905809 (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:40:y:2020:i:2:p:156-169

DOI: 10.1177/0272989X20905809

Access Statistics for this article

More articles in Medical Decision Making
Bibliographic data for series maintained by SAGE Publications ().