Cost burden of type 2 diabetes in Germany: results from the population-based KORA studies

Abstract

ObjectiveTo examine the impact of type 2 diabetes on direct and indirect costs and to describe the effect of relevant diabetes-related factors, such as type of treatment or glycaemic control on direct costs.DesignBottom-up excess cost analysis from a societal perspective based on population-based survey data.Participants9160 observations from 6803 individuals aged 31–96 years (9.6% with type 2 diabetes) from the population-based KORA (Cooperative Health Research in the Region of Augsburg) studies in Southern Germany.Outcome measuresHealthcare usage, productivity losses, and resulting direct and indirect costs.MethodsInformation on diabetes status, biomedical/sociodemographic variables, medical history and on healthcare usage and productivity losses was assessed in standardised interviews and examinations. Healthcare usage and productivity losses were costed with reference to unit prices and excess costs of type 2 diabetes were calculated using generalised linear models.ResultsIndividuals with type 2 diabetes had 1.81 (95% CI 1.56 to 2.11) times higher direct (€3352 vs €1849) and 2.07 (1.51 to 2.84) times higher indirect (€4103 vs €1981) annual costs than those without diabetes. Cardiovascular complications, a long diabetes duration and treatment with insulin were significantly associated with increased direct costs; however, glycaemic control was only weakly insignificantly associated with costs.ConclusionsThis study illustrates the substantial direct and indirect societal cost burden of type 2 diabetes in Germany. Strong effort is needed to optimise care to avoid progression of the disease and costly complications.

Healthcare costs of Type 2 diabetes in Germany

“…The AOK is the largest statutory health insurance fund in Germany . In 2010, per capita costs of €5,239 for all people with diabetes were calculated by the CoDIM study ; however, the current cost estimation exceeded the calculations by two other studies, one of them was based on 2.7 million insured people in AOK statutory health insurance funds throughout Germany (€4,377 for people with Type 2 diabetes) and the other was based on 9160 observations from KORA (Cooperative Health Research in the Region of Augsburg, Germany) studies (€3,352 for people with Type 2 diabetes) . Furthermore, a large difference existed between the present results and those of the cost‐of‐illness‐study by Bächle et al .…”

Cost-of-Illness Analysis of Type 2 Diabetes Mellitus in the Russian Federation: Results from Russian multicenter observational pharmacoepidemiologic study of diabetes care for patients with type 2 diabetes mellitus (FORSIGHT-Т2DM)

“…прямые затраты на 1 больного с СД2 составляли $7888 [24], в Ита-лии -€3660,8 (2012 г.) [26], в Южной Корее -$1938,8 [27], в Германии -5262 € [28], в Испании в 2011 г. -€3110,1 [29].…”

“…Полученные результаты расчетов совпадают с данны-ми зарубежных отчетов о стоимости болезни: наличие осложнений увеличивает стоимость госпитализации в 2-5 раз (наибольшее влияние на увеличение затрат оказывает наличие микрососудистых осложнений и сер-дечно-сосудистых заболеваний) [25,28,32].…”

Advancing Measurement of Diabetes at the Population Level

“…To analyze the burden or impacts of diabetes, researchers often apply bottom up studies using individual-level data, i.e., they apply econometric methods to compare utilization and costs between comparable individuals with and without the disease over a predefined time horizon, typically a year [33, 34]. Other cost of illness studies also often apply top-down approaches that use aggregated data along with population-attributable fractions to estimate attributable costs [35].…”