The impact of diabetes‐related complications on healthcare costs: results from the United Kingdom Prospective Diabetes Study (UKPDS Study No. 65)

Abstract

Aims To develop a model for estimating the immediate and long-term healthcare costs associated with seven diabetes-related complications in patients with Type 2 diabetes participating in the UK Prospective Diabetes Study (UKPDS). MethodsThe costs associated with some major complications were estimated using data on 5102 UKPDS patients (mean age 52.4 years at diagnosis). In-patient and out-patient costs were estimated using multiple regression analysis based on costs calculated from the length of admission multiplied by the average specialty cost and a survey of 3488 UKPDS patients' healthcare usage conducted in 1996-1997. ResultsUsing the model, the estimate of the cost of first complications were as follows: amputation £8459 (95% confidence interval £5295, £13 200); nonfatal myocardial infarction £4070 (£3580, £4722); fatal myocardial infarction £1152 (£941, £1396); fatal stroke £3383 (£1935, £5431); non-fatal stroke £2367 (£1599, £3274); ischaemic heart disease £1959 (£1467, £2541); heart failure £2221 (£1690, £2896); cataract extraction £1553 (£1320, £1855); and blindness in one eye £872 (£526, £1299). The annual average in-patient cost of events in subsequent years ranged from £631 (£403, £896) for heart failure to £105 (£80, £142) for cataract extraction. Non-in-patient costs for macrovascular complications were £315 (£247, £394) and for microvascular complications were £273 (£215, £343) in the year of the event. In each subsequent year the costs were, respectively, £258 (£228, £297) and £204 (£181, £255).Conclusions These results provide estimates of the immediate and long-term healthcare costs associated with seven diabetes-related complications.

Cost of poor adherence to anti-hypertensive therapy in five European countries

“…The total cost of CV events attributable to hypertension was estimated to exceed €51.3 [18] 81,843,743 [19] 46,815,916 [20] 65,281,000 [21] 52,642,500 [22] Percentage of females 51.48 % [18] 50.87 % [19] 50.65 % [20] 51.57 % [21] 50.84 % [22] Percentage of females; age C 30 years 71.76 % [18] 70.86 % [19] 69.37 % [20] 64.76 % [21] 63.54 % [22] Percentage of males; age C 30 years 68.59 % [18] 68.33 % [19] 67.05 % [20] 61.39 % [21] 61. 17 Percentage of diagnosed and treated hypertensive subjects 73.00 % [30] 77.00 % [31] 59.40 % [26] 56.92 % [27,29] 58.38 % [32] Percentage of diagnosed patients with adherence C80 % 41.50 % [9] 66.90 % [13] 39.40 % [14] 39.00 % [12] 56.85 % [11] billion over a time span of 10 years (range €5.0 in England and €17.1 in Germany). Considering only the costs associated with diagnosed and treated patients, drug cost is estimated, on average, to represent 37 % (range 10 % in England and 71 % in Spain) of the total cost of the disease and the remaining part being attributed to hospitalisations (Table 5).…”

“…A level of good adherence needed for a pharmacological treatment to be effective is widely recognized to be around 80 % of the prescribed therapy [9]. Existing research shows that in several European countries \60 % of treated hypertensive subjects have an adherence to their treatment over 80 % [10][11][12][13][14]. Poor adherence results in severe losses in terms of clinical efficacy and economic efficiency, especially as the cardiovascular events that full adherence could avoid translate into greater hospitalisation costs.…”

Screening for glucose intolerance and development of a lifestyle education programme for prevention of type 2 diabetes in a population with intellectual disabilities: the STOP Diabetes research project

“…264 At the present time, the following costs incorporated are: A summary of all of the unit costs used in the model and their sources are shown in Table 47. 264,[307][308][309][310][311][312][313][314][315][316][317][318][319][320][321][322][323][324][325][326] …”

“…The costs of fatal stroke and MI were obtained from two separate studies, 307,311 and it was assumed that 50% of individuals would incur these costs. The costs of congestive heart failure were estimated from the UKPDS costing study 316 for complications related to diabetes.…”

Ethnic-Specific Obesity Cutoffs for Diabetes Risk: Cross-sectional Study of 490,288 UK Biobank Participants

“…mortality in the U.K. (4-7) and a major contributor to health care costs (6)(7)(8). Both obesity and diabetes are increasing in prevalence, particularly among people from nonwhite ethnic groups (6,7).…”