ObjectiveThe increasingly high levels of overweight and obesity among the workforce are accompanied by a hidden cost burden due to losses in productivity. This study reviews the extent of indirect cost of overweight and obesity.MethodsA systematic search was conducted in eight electronic databases (PubMed, Cochrane Library, Web of Science Core Collection, PsychInfo, Cinahl, EconLit and ClinicalTrial.gov). Additional studies were added from reference lists of original studies and reviews. Studies were eligible if they were published between January 2000 and June 2017 and included monetary estimates of indirect costs of overweight and obesity. The authors reviewed studies independently and assessed their quality.ResultsOf the 3626 search results, 50 studies met the inclusion criteria. A narrative synthesis of the reviewed studies revealed substantial costs due to lost productivity among workers with obesity. Especially absenteeism and presenteeism contribute to high indirect costs. However, the methodologies and results vary greatly, especially regarding the cost of overweight, which was even associated with lower indirect costs than normal weight in three studies.ConclusionThe evidence predominantly confirms substantial short-term and long-term indirect costs of overweight and obesity in the absence of effective customised prevention programmes and thus demonstrates the extent of the burden of obesity beyond the healthcare sector.

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Aim Despite the growing number of elderly cancer patients, health economic evaluations have not put enough attention on this patient group. We reflect on the current state of health economic evaluations for geriatric patients and present suggestions for improvements. Method We reviewed the scientific literature on health economic evaluations for geriatric patients in Germany and internationally. Additionally, we conducted a scoping review on cost-utility analyses on cancer treatment for older patients (> 60 years). Results The literature review resulted in eight relevant studies. Besides the paucity of economic evaluations for elderly patients, we also present quality limitations. From the literature, we identify four recommendations regarding cost calculation, geriatric assessment, patient decision-making and quality of life on how to design better economic evaluations for geriatric cancer treatment. Conclusion The demographic change requires more attention regarding elderly patients in health economics. Including patients above 70 years of age in health economic evaluations and improving cost-utility analyses will help to improve resource allocations and effective healthcare for the elderly.