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Estimated cost of diabetes tops $327B in 2017
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The economic burden of diabetes grew by 25% between 2012 and 2017, rising from $261 billion to $327 billion after adjustment for inflation, according to an analysis of survey and claims data published in Diabetes Care.
“From our new economics report, it is very clear that diabetes bears a significant impact on our nation, both in its toll on the lives of the millions affected by it, and the economic costs for all,” William T. Cefalu, MD, chief scientific, medical and mission officer of the American Diabetes Association, said in a press release. “The most important solution we have is continued and increased investment in critical diabetes research, care and prevention to improve diagnosis and treatment, and to help us turn the tide through diabetes prevention. These efforts can help us to improve health outcomes for people with diabetes — and hopefully decrease the cost of diabetes.”
In a prevalence-based approach, Wenya Yang, MPA, MA, of the Lewin Group in Falls Church, Virginia, and colleagues, under the direction of the ADA, combined 2017 demographic data for the U.S. with data on diabetes prevalence, epidemiology, health care costs and other economic measures into a cost of diabetes model. State-level data included the American Community Survey, the Behavioral Risk Factor Surveillance System, Medicare Current Beneficiary Survey and Long-Term Care Minimum Data Set, using the most recent figures available for each. National-level data included the Current Population Survey, Medical Expenditure Panel Survey, National Ambulatory Medical Care Survey, National Hospital Ambulatory Medical Care Survey, National Health Interview Survey, National Inpatient Sample and Medicare 5% sample Standard Analytical Files. Indirect costs attributed to diabetes factored into the model included workdays missed due to health conditions (absenteeism), reduced work productivity while working due to health conditions (presenteeism), reduced workforce participation due to disability, household productivity losses and lost productivity due to premature mortality.
In 2017, an estimated 24.7 million people, or 7.6% of the U.S. population, had diagnosed diabetes. The estimated national cost of diabetes in 2017 was $327 billion, with $237 billion, or 73% of that cost, attributed to direct health care expenditures, and $90 billion, or 27% of the cost, attributed to lost productivity from work-related absenteeism, unemployment from chronic disability and premature mortality.
“Particularly noteworthy is that excess costs associated with medications constitute 43% of the total direct medical burden,” the researchers wrote. “This includes nearly $15 billion for insulin, $15.9 billion for other antidiabetes agents and $71.2 billion in excess use of other prescription medications attributed to higher disease prevalence associated with diabetes.”
In calculating health resource use, researchers found that 40.3 million of the projected 162 million hospital inpatient days in the U.S. in 2017 were incurred by people with diabetes, whereas one-fourth of all nursing or residential facility days were incurred by people with diabetes. Additionally, in people with diabetes, about half of all physician office visits, hospital outpatient visits and medication prescriptions excluding insulin and other antidiabetes agents were attributed to diabetes.
Researchers found that the largest contributors to the cost of diabetes are higher use of prescription medications beyond antihyperglycemic medications ($71.2 billion), higher use of hospital inpatient services ($69.7 billion), diabetes supplies ($34.6 billion) and more office visits to health care providers ($30 billion).
The total indirect cost of diabetes is estimated at $89.9 billion, according to researchers, with the leading contributors being reduced employment ($37.5 billion), presenteeism ($26.9 billion) and premature mortality ($19.9 billion).
The researchers noted that the annual per capita health care expenditure for people with diabetes in 2017 was 2.3 times higher vs. those without diabetes, with results persisting after adjusting for age and sex.
“Outside of the chronic complication categories modeled, the presence of diabetes is associated with greater use of health care services in general — including longer stays in the hospital regardless of primary reason for hospitalization,” the researchers wrote. “This underscores that simply aggregating all costs associated only with diabetes diagnosis codes grossly underestimates the medical costs directly attributable to diabetes.” – by Regina Schaffer
Disclosures: The authors report no relevant financial disclosures.
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