Economic impact of hypoglycemia on healthcare in Spain

Abstract

Diabetes mellitus has a major impact on costs for healthcare and society. The estimation for 2010 is that investment in diabetes will reach 11.6% of public healthcare expenses worldwide. The expected rise in the prevalence of diabetes over the coming decades may create problems for the sustainability of healthcare systems, such as those in Spain. The rise in direct costs is the main issue in diabetes, especially the treatment of acute and chronic complications that often need hospital care. Severe hypoglycemia (SH) is the most frequent acute complication. In Spain, the incidence of SH is estimated at two episodes per patient per year for Type 1 diabetes and one to two episodes for advanced Type 2 diabetes requiring insulin treatment. Although results vary, Spanish national data provide an estimated cost of approximately €3500 per SH episode. It also has a major influence on indirect costs, mainly related to reduced productivity, absenteeism and occasionally early retirement, and affects direct health, such as quality of life. As a result of SH, patients acquire a fear of new hypoglycemic episodes, which makes them modify their behavior and habits and, in the long term, has the potential to negatively impact metabolic control. Educational programs for healthcare professionals and patients with diabetes, increased involvement of patients in the management of their illness and regular self-measurement of blood glucose are all strategies aimed at minimizing the social and economic effects of severe hypoglycemia.

Incidence and care‐related costs of severe hypoglycaemia requiring emergency treatment in Andalusia (Spain): the PAUEPAD project

“…Event rates for severe hypoglycaemia in people with Type 1 diabetes range from 115 to 320 per 100 person‐years 6, 7, 8, 9. Severe hypoglycaemia in insulin‐treated individuals with Type 2 diabetes has been shown to occur at rates of 10–70 episodes per 100 person‐years 6, 7, 8, 9. However, when broader populations of people with Type 2 diabetes are included, the incidence of severe hypoglycaemia ranges from 0 to 3 per 100 person‐years in adults with Type 2 diabetes 7.…”

Association Between Hypoglycemia and Fall-Related Events in Type 2 Diabetes Mellitus: Analysis of a U.S. Commercial Database

“…episode of severe hypoglycemia. 8 A Korean study reported costs ranging from $135.50 to $1,391.00 per episode of severe hypoglycemia. 9 Swedish studies report the direct costs of hypoglycemia per patient being $12.90 for a 1-month period, while the indirect costs are $14.10 for a 1-month period, with the total cost (in base case) of hypoglycemia in Sweden being approximately €4,250,000 (~$5.74 million) per year.…”

The cost of managing severe hypoglycemic episodes in Type 2 diabetic patients

“…Hypoglycemia is one of the most frequent and undesirable antidiabetic drug-related adverse events [4]. Although most hypoglycemic episodes can be managed by the patients or by non-medical third-party assistance, in its severe state, it is likely the most common endocrine emergency [5,6] and usually requires hospital assistance [7]. Hypoglycemia and fear of hypoglycemia are the main factors limiting adequate metabolic control in Type 1 and 2 diabetes [8].…”