McKinsey: Women more likely to be obese than men

27 January 2015

Women have a substantial higher chance of being obese than men, reveals a recent study from McKinsey & Company, with the relationship becoming increasingly true in countries where obesity is a major issue. For policy makers, it implies that careful thought needs to be given about healthcare strategy and intervention plans, in particular in countries where obesity has deep roots within culture and society.

In the report ‘Overcoming Obesity: An Initial Economic Analysis’, McKinsey & Company looks into the economic and societal effects of obesity. The firm finds that globally obesity is one of the three top social burdens generated by humanity’s contemporary lifestyle, generating a total burden of $2.0 trillion per year, trailing just smoking and violence / terrorism. There are also massive social costs, with 2.8 million of a total 59 million deaths per year tied to obesity. In the UK the price tag of obesity is estimated at $73 billion a year, making it after smoking the second largest health liability of the country’s economy.

Obesity is one of the top three global burdens

Gender and obesity
One of the areas researched by the strategy consultants is the relationship between gender and obesity. Key finding is that while obesity is something that can, and does, affect both genders, it predominantly affects women. Of the 196 countries for which the OECD has data available on obesity, obesity is highest among women in 168 of them. The effect is exaggerated in the countries with the highest overall obesity prevalence – in the top 20 countries in which obesity is most prevalent, obese women outnumber men in all of them. For instance, in Kuwait, where 42% of the population is obese, the difference between male and female prevalence is 12%, with 38% and 50% respectively. In Egypt the difference between gender is the greatest at 24%, while in the United States the difference is 4% in favour of women. In Lebanon a quarter of men is obese, with the female average 7 percentage points higher.

The gender disparity is according to the researchers the result of a complex interplay of social, cultural, and biological factors.

Top 20 countries with highest obesity prevalence

Obese and opportunities
The report also highlights that there are certain socioeconomic burdens that obese women bear over their obese opposites. The higher prevalence in women implies that they carry more of the burden of obesity, says McKinsey, including reduced life expectancy, greater risk of obesity-related disease, poorer career opportunities* and increased medical costs. The authors recommend that in countries with a large obesity gender gaps, careful thought needs to be given about how best to intervene, particularly in countries where effective mitigation may require overcoming strong social and cultural barriers.

* A recent study in the US showed that obese teenage girls were less likely to enrol in college than girls in their age group who are not obese; this did not hold true for teenage boys. Enrolment by girls in high schools that had relatively few obese teenagers was also lower, suggesting that self-perception and confidence play a role. Research has also shown that obese women earn less than those who are not obese and that this income penalty continues throughout their careers. Men are less disadvantaged as women in this respect.


Medicine economic model creates negative health outcomes

26 March 2019

Profit-driven production of antibiotics has held back the development of vital medical breakthroughs, according to a new report. Analysis from a leading strategy consultancy suggests that a change in economic model and new incentives could prompt pharmaceutical giants to develop cures to major diseases, which could be affordable at scale.

The much maligned pharmaceutical industry has long been criticised for its failure to focus on deep seated issues in public health. For instance, there is increasing concern around microbial resistance, with some bacteria now resistant to all known antibiotics. Combating that requires new antibiotics – but drug companies see little profit in the field, and therefore have not seriously invested in it. Another instance of concern is a focus on treating symptoms rather than curing the diseases themselves, with such treatments requiring long-term payment to mitigate symptoms, rather than one-time cures being delivered.

Cases like the so-called “Pharma Bro” Martin Shkreli – who received widespread criticism when his company obtained the manufacturing license for the antiparasitic drug Daraprim and raised its price by a factor of 56 (from US$13.5 to $750 per pill – underline the failing of this system to meet the needs of society. New analysis from Boston Consulting Group (BCG) seeks to challenge the current economic model and its inherent failures in favour of a model that creates greater social good while also generating steady reliable returns for pharma companies. The analysis appears in the firm’s ‘Aligning Economic Incentives to Eradicate Diseases’ report.

Different pricing model makes cures more accessible

One example is Hepatitis C. The disease is massively damaging to human life, with considerable negative impacts on patients and society. Treatments have existed for decades, which manage the virus but did not cure it. These treatments had significant side effects however, which saw people not complete rounds – which then resulted in expensive emergency care and secondary health costs.

In 2013 a treatment was developed that effectively cured the virus in 8-12 weeks. The treatment has few side effects and works in most patients. However, five years later fewer than 10% of people globally with the virus have had the cure – largely because of prohibitive costs. The ambition to remove this disease and its large negative drag on the lives of millions by 2030 is becoming increasingly unlikely. The issue is cost.

The current economic model used by pharmaceutical companies mean that early adopters pay sky high prices as the company seeks to recoup costs, with the price eventually coming down to levels at which a larger segment can afford to access the drug – before its generic releases sees mass uptake. This model creates considerable initial barriers, and long-term social costs.

The report subsequently proposes a different pricing model that would see the price of a new drug kept at a constant level for its lifetime but have that level set considerably lower than the current model - which is focused on recouping costs immediately. Under the firm’s model, within 12 years of the Hepatitis C drug’s discovery, up to 96% of the population could be cured, at a cost 30% lower than the UN model and with a cure rate almost 50 percentage points higher than the base model.

The PLA scenario has better social outcomes than the traditional model

A change in model would, according to the firm’s analysis for HCP, triple the number of patients cured within 2 years, reduce the number of liver disease deaths by 60%, reduce total costs to payers by 30% (due to fewer additional costs on healthcare systems), while creating higher and more predictable revenue streams for pharma companies.

“There are many barriers to curing this population, but the dilemma created by current pricing models is one of the biggest,” said Dave Matthews, a BCG Principal and study co-author. The firm adds, “The dilemma results because a high price per patient makes treating everyone prohibitively expensive while an affordable price is too low for pharmaceutical companies to earn back their investments.”

Matthews concluded, “Switching to a population-based model such as the PLA not only makes the cure affordable, but also creates strong motivation to identify, diagnose, and treat as many patients as possible before the license expires.”

Related: Ten year deal activity in pharmaceuticals industry stands at $2.4 trillion.