The prevalence of multi-comorbid patients in the US: highlighting the need for multi-indication value assessments
Date:
This study estimates the population-level prevalence of seven interrelated diseases within the US, describes the substantial overlap between these diseases, and quantifies the prevalence of multi-comorbid patients.
Abstract: In the US, more than 40% of adults are overweight or obese. There is an interrelationship between obesity, cardiovascular disease (CVD), chronic kidney disease and metabolic diseases referred to as cardiovascular-kidney-metabolic (CKM) syndrome. The objective of this study was to estimate the prevalence of single and multiple CKM comorbidities in the US. We extrapolated contemporary NHANES data (2021–2022), to estimate the US adult population living with one or more CKM comorbidities: obesity, hypertension, dyslipidemia, type 2 diabetes, CVD, poor kidney health, or poor liver health. We estimated the population-level prevalence of each of 128 unique combinations of comorbidities. An estimated 149 million (59.6%) US adults have one or more CKM comorbidity. Obesity was the most prevalent condition (42.5%), followed by hypertension (24.1%), dyslipidemia (21.8%), T2D (10.6%), CVD (9.1%), poor liver health (3.1%), and poor kidney health (2.7%). The prevalence of multimorbidity was high; overall, 76 million (29.9%) patients had at least two comorbidities of interest and 48.8% of adults with obesity had at least one comorbidity. The most common combinations were obesity with hypertension (4.5%), followed by obesity with hypertension and dyslipidemia (2.8%). Where multi-indication treatment effects span multiple distinct, but biologically connected indications, such as GLP-1 RAs, value assessments need to quantify the total benefit experienced by a patient receiving a single therapy.
Lay abstract: Many diseases are interrelated. Obesity, cardiovascular health, kidney health are closely linked. This work quantifies the number of people living with each disease and those living with more than one.
Recommended citation: Padgett, T., Roberts, G., Evans, M., McEwan, P. (2025) The prevalence of multi-comorbid patients in the US: highlighting the need for multi-indication value assessments. ISPOR US 2025, 14 May 2025; Poster EE189.