Type 2 Diabetes in Turkey – A Cost of Illness Study

Malhan, S; Schwarzbard, J; Sahin, Toros; Bilgic, Ayse; Atanasov, Petar; Ramachandran, Ambady; Mbanya, J.C.; Aschner, Pablo; Gagliardino, J.J.; İlkova, Hasan; Jc, Chan

doi:10.1016/j.jval.2016.09.1857

Cited by 3 publications

(3 citation statements)

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“…In LMIC, many people with diabetes receive a late diagnosis, at the time when patients present with retinopathy, nephropathy, foot ulceration and other complications, with a consequent loss of treatment efficacy [ 30 ]. Most of the direct costs of T2D treatment are due to diabetes complications [ 8 , 31 – 35 ]. This is particularly true in the case of hospitalizations due to diabetes complications, which mobilize many human resources and require expensive medical procedures (i.e.…”

Section: Discussionmentioning

confidence: 99%

Glycemic Control and Prevention of Diabetic Complications in Low- and Middle-Income Countries: An Expert Opinion

et al. 2021

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Introduction Trends on glycemic control and diabetes complications are known for high-income countries, but comprehensive data from low- and middle-income countries (LMIC) are lacking. Methods This is an expert opinion based on two retrospective studies. Here we examine the recent subset analysis of relevant data from the IDMPS Wave 7 (International Diabetes Management-Practices Study, 2015–2016) and the GOAL study conducted in multiple LMICs. Results Wave 7 sub-analysis was performed in 6113 people with type 2 diabetes from 24 LMIC. Poorly controlled diabetes (hemogloblin A1c [HbA1c] ≥ 7%) was found in 58.6, 73.0 and 78.3% of participants with diabetes duration of < 5, 5–12 and > 12 years, respectively (in association with a high prevalence of macro- and microvascular complications). Moreover, 37.7% of participants with diabetes duration of 5–12 years were treated only with oral antihyperglycemic drugs. The GOAL study investigated the efficacy of insulin in 2704 poorly controlled participants (mean HbA1c 9.7%; diabetes duration 10.1 ± 6.7 years; 10 LMIC). A significant 2% reduction in mean HbA1c levels was observed after 12 months of treatment. Only 7.2% of participants experienced a symptomatic episode of hypoglycemia (nocturnal or severe hypoglycemia events were infrequent). Conclusion The rate of well-controlled participants (HbA1c < 7.0%) in the Wave 7 sub-analysis was lower than that observed in the USA (NHANES survey) or in European countries (GUIDANCE study), and the incidence of microvascular complications was higher. The GOAL study showed that insulin treatment improves glycemic control and reduces this gap. The Expert Panel recommends intensifying diabetes treatment as soon as possible, as well as patients’ education and other preventive measures, initiatives which require modest costs compared to hospitalization and treatment of diabetes complications.

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Section: Discussionmentioning

confidence: 99%

Glycemic Control and Prevention of Diabetic Complications in Low- and Middle-Income Countries: An Expert Opinion

et al. 2021

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“… 46 Our annual cost estimates for T2DM were 12,098 TRY (690 USD), which is in in line with a local study published earlier in 2015. 47 The 2015 Turkish publication utilized HCRU data from the International Diabetes Management Practice Study, 48 and authors estimated an annual cost of T2DM per patient of 13,048 TRY (2015 TRY adjusted to 2022 TRY; 744 USD). The cost for heart failure (16,639 TRY; 948 USD) was also observed to be similar to costs previously observed in Poland 49 (815 EUR in 2012; 994 EUR/ 1035 USD in 2022) and Portugal (1159 EUR in 2014; 1389 EUR/ 1447 USD in 2022).…”

Section: Discussionmentioning

confidence: 99%

“…46 Our annual cost estimates for T2DM were 12,098 TRY (690 USD), which is in in line with a local study published earlier in 2015. 47 The 2015 Turkish publication utilized HCRU data from the International Diabetes Management Practice Study, 48 and authors estimated an annual cost of T2DM per patient of 13,048 TRY (2015 TRY adjusted to 2022 TRY; 744 USD). The cost for heart failure (16,639 TRY; 948 USD) was also observed to be similar to costs previously observed in Poland 49 50 Both Polish and Portuguese studies were similarly undertaken from the public health system perspective and representative of chronic heart failure patients resource demands across the full spectrum of class I-IV.…”

Section: Discussionmentioning

confidence: 99%

The Economic Impact of Obesity in Turkey: A Micro-Costing Analysis

Gogas Yavuz,

Akhtar,

Low

et al. 2024

CEOR

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Background Turkey currently has the highest obesity prevalence among its European counterparts. 32% and 61% of the population live with obesity and overweight, respectively. Overweight and obesity are linked to non-communicable diseases that incur incremental health and economic costs. The significant public health concern warrants an assessment of the cost of obesity. Methods A micro-costing approach from the public payer perspective was conducted to estimate direct healthcare costs associated with ten obesity-related comorbidities (ORCs) in Turkey. Clinical practice guidelines and a systematic literature review informed ORCs and the respective cost categories. This was subsequently validated by a steering committee comprising seven experts. Seventy public sector physicians were surveyed to estimate healthcare resource use. Unit costs were derived from Social Security Institute’s Healthcare Implementation Communique. Cost items were summed to determine the annual cost per patient per ORC, which was validated by the steering committee. Medical inflation was considered in a scenario analysis that varied resource unit costs. Results Chronic kidney disease, heart failure and type 2 diabetes are the costliest ORCs, incurring an annual cost of 28,600 TRY, 16,639 TRY and 11,993 TRY, respectively. Individuals in Turkey with any ORC triggered direct healthcare costs ranging 1857–28,600 TRY annually. Costs were driven by tertiary care resources arising from treatment-related adverse events, disease complications and inpatient procedures. In the scenario analysis, medical resource unit costs were inflated by 18.7% and 39.4%, triggering an average increase in cost across all ORCs of 1998 TRY and 4210 TRY, respectively. Conclusion Our findings confirm that obesity and its complications result in significant financial burden to the public healthcare system. By quantifying the burden of obesity across a comprehensive spectrum of ORCs, our study aims to support the economic case for investing in appropriate obesity interventions.

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