The health economics burden of sarcopenia: a systematic review

Despite of better knowledge about sarcopenia, an optimal understanding of its consequences from a public health perspective remains a challenge. Specifically, the economic burden of the illness is unclear. As a support for the public health policy makers and other health actors, our objective was to perform a systematic review of the literature comparing healthcare costs between sarcopenic and non-sarcopenic patients (under the registration number CRD42018099291). A research of relevant articles was conducted among electronical databases (MEDLINE and Scopus). Rigorous eligibility criteria were established (e.g., subjects with sarcopenia, both men and women,mean age of the sarcopenic population) and applied by two investigators to include suitable studies. The narrative report described that, at the first screening phase, performed by 2 independent reviewers, covered 455 references. Finally, 14 relevant studies have been included in the analysis. Overall, we noted an important heterogeneity between studies in the way of assessing sarcopenia (i.e. operational definitions, tools and cut-offs used). There were also large variation between studies in their cost analysis settings (i.e., discrepancies in time horizon, type and source of economic data). Most of the studies focused on hospitalization costs following a surgery for a specific disease such as cancer. Finally, 11 out of 14 studies tended to report higher health care costs in sarcopenic patients. However, most of the included studies have important methodological bias (i.e. potential confusion factors rarely taken into account), with a low to moderate quality scores. More standardized research, taking into account all limitations of the current studies, should be conducted to assess the true impact of sarcopenia on health care consumption.