Economics of hypothalamic obesity in patients with craniopharyngioma and other rare sellar/suprasellar tumors

Julian Witte (), Nicolas Touchot (), Bastian Surmann (), Kylie Braegelmann (), Mathias Flume (), Julia Beckhaus (), Carsten Friedrich () and Hermann L. Müller ()
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Julian Witte: Vandage GmbH
Nicolas Touchot: Rhythm Pharmaceuticals
Bastian Surmann: Vandage GmbH
Kylie Braegelmann: Vandage GmbH
Mathias Flume: Gene Access GmbH
Julia Beckhaus: University Children’s Hospital, Carl von Ossietzky Universität, Klinikum Oldenburg AöR
Carsten Friedrich: University Children’s Hospital, Carl von Ossietzky Universität, Klinikum Oldenburg AöR
Hermann L. Müller: University Children’s Hospital, Carl von Ossietzky Universität, Klinikum Oldenburg AöR

The European Journal of Health Economics, 2025, vol. 26, issue 9, No 3, 1557-1567

Abstract: Abstract Background Rapid and abnormal weight gain resulting in severe persistent obesity due to physical, tumor- and/or treatment-related damage to the hypothalamus, is called acquired hypothalamic obesity (aHO), and is often linked to craniopharyngioma and/or sellar/suprasellar tumors. Here, we examine the healthcare resource use (HCRU) and costs of aHO following treatment of these tumors. Methods We used a retrospective matched cohort design with German statutory health insurance data on 5.42 million people from 2010 to 2021. We applied a novel three-step approach using diagnostic and prescription data to identify patients with treatment- or tumor-related (TTR)-aHO. We measured HCRU and costs across hospitalizations, outpatient visits, visits per specialist group, and outpatient prescription medications. Results Compared to non-HO obesity, TTR-aHO is associated with increased hospitalizations, increased outpatient physician visits, and increased prescription use in the two years after incident tumor surgery/radiotherapy. Excess costs of TTR-aHO are €19,900 per patient in the first year and €10,700 in the second, driven by inpatient costs. Cost-intensive hormone replacement therapies like somatropin lead to a sharp increase in prescription costs in the second year. Conclusions This study provides the first real-world analysis of TTR-aHO economics, emphasizing the importance of HCRU and costs for decision-making. Previously, economic evaluations have been missing due to the lack of a standard method to identify patients with aHO in retrospective studies. Using a new identification approach, the study reveals that TTR-aHO poses a significant burden in extensive treatment requirements for patients and high related costs for the healthcare system.

Keywords: Hypothalamic obesity; Tumor/treatment related aHO; Rare sellar/suprasellar tumors; Craniopharyngioma; Endocrinology (search for similar items in EconPapers)
Date: 2025
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DOI: 10.1007/s10198-025-01786-3

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