IDF Diabetes Atlas - Cost of Diabetes

IDF Diabetes Atlas
The calculated estimates of the current direct cost of diabetes care worldwide are provided in the data tables here. This is the first time that such estimates have been made for so many countries. The calculated estimates use a formula described in the section below. The same method, together with predictions of the future burden of diabetes in these countries, is used to estimate the likely future direct cost burden of the disease in 2025. These future predictions of cost are as alarming as the future predictions of prevalence. They suggest that, unless effective prevention measures are introduced, expenditure devoted to diabetes and its complications will dominate the health economies of many countries by the end of the first quarter of this century.
Direct costs: calculations using formulae

The formulae given in the box below enable countries or regions to estimate direct healthcare costs of diabetes, or any other disease, without the need for costly and time consuming empirical studies.

Of the three variables needed to make these calculations, estimates of the prevalence of diabetes (P) are now available for every country and the total healthcare budget (THCB) for most countries is available from published sources. However, R, the ratio of the cost of care for people with diabetes compared with the cost of care of people without diabetes, is not widely available in various countries and some assumptions need to be made in order to use these formulae.

Current data suggest that, at least for countries with high or moderate incomes, the value of R lies between 2 and 3, eg the estimate of 2.6 for the United States1Rubin R, Altman WM, et al. Healthcare expenditures for people with diabetes mellitus, 1992. J Clin Endocrinol Metab 1994; 78: 809A-809F..

The data tables give estimates of the cost of diabetes care for persons aged 20-79 using the first formula in the box above. The tables use population estimates and diabetes prevalence estimates for the 20-79 year age group for 2003 as shown in the tables on the 'Prevalence' page of this website, and data on per capita health expenditure (in international dollars) as presented in the World Health Report for 20022World Health Organization. The World Health Report 2002. World Health Organization, Geneva, 2003.. By multiplying the 20-79 year population figures by the per capita health expenditures, the total healthcare budget for that age group is derived. Calculations are then presented for values of R of 2 and 3. The figure below shows the values of R of 2 and 3 by region.

The calculated estimates for some countries can be validated against empirically derived estimates. For example, the American Diabetes Association's latest estimate for the direct cost of diabetes over all age groups in the USA is US$91.8 billion in 20023American Diabetes Association. Economic Costs of Diabetes in the U.S. in 2002. Diabetes Care 2003; 26:917-932.. This is within the range of calculated costs, by formula, using the diabetes prevalence and total healthcare budget figures for the USA which is 66.7 billion international dollars for R = 2 to 124.2 billion international dollars for R = 3 (see Data tables - North American Region). The empirically derived figure of US$91.8 billion corresponds to a value of R lying between 2.5 and 2.6.
Predictions of the future costs of diabetes

As the prevalence of diabetes increases, the likelihood is that costs will also rise although the magnitude will depend on a number of things, particularly, the extent to which complications will be prevented or delayed.

Using, again, the first formula listed in the box above together with the predictions of diabetes prevalence in 2025, the future costs of diabetes can be calculated given certain assumptions. If it is assumed that per capita health expenditure of the countries will not increase in real terms, then each country's total health expenditure in 2025 for people aged 20-79 years can be calculated using this per capita figure and the predicted population for that year.

The data table, 'Predictions of the future costs of diabetes' lists the overall predictions by region (see also figure below) and, for each region, the predicted costs for the country with the highest diabetes care expenditure expressed as a percentage of total health expenditure.

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