Abstract

AimTo determine the costs associated with diabetes to governments, people with diabetes and their carers, and its impact on quality of life in two Pacific Island countries—the Solomon Islands and Nauru.Materials and MethodsThis cross-sectional cost of illness study was conducted on 330 people with type 2 diabetes (197 from the Solomon Islands and 133 from Nauru) using a structured cost of illness survey questionnaire adapted from the Australian DiabCo$t study. Quality of life was measured by the EQ-5D Visual Analogue Scale.ResultsThere were 330 respondents (50% female; mean duration of diabetes 10.9 years; mean age 52.6 years). The estimated annual national cost of diabetes incurred by the Solomon Islands government was AUD12.8 million (AUD281 per person/year) and by Nauru government was AUD1.2 million (AUD747 per person/year). The major contribution to the government costs was inpatient services cost (71% in the Solomon Islands and 83% in Nauru). Annual expenditure for diabetes was approximately 20% of the governments’ annual health care expenditure. Considerable absenteeism and retirement from work due to diabetes was found.ConclusionsThis study found substantial public and personal costs associated with diabetes. The findings provide objective data on which health policy, funding and planning decisions about the prevention and control of diabetes in the Solomon Islands and Nauru can be reliably based and subsequently evaluated.

Highlights

  • Diabetes imposes a substantial economic burden on national health systems globally [1,2]

  • The estimated annual national cost of diabetes incurred by the Solomon Islands government was AUD12.8 million (AUD281 per person/year) and by Nauru government was AUD1.2 million (AUD747 per person/year)

  • This study found substantial public and personal costs associated with diabetes

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Summary

Introduction

Diabetes imposes a substantial economic burden on national health systems globally [1,2]. It is predicted that global health expenditure on diabetes will increase from USD376 billion in 2010 to some USD490 billion by 2030 [1]. Given the predicted increase in global diabetes prevalence from 382 million in 2013 to 592 million by 2035 [3], this raises serious concerns about the sustainability of the health systems especially in low and middle income countries (LMICS). In addition to health care expenditure, diabetes can reduce household income through lost employment due to illness and early retirement [6]. It is not surprising that perhaps the greatest financial concerns about diabetes relate to its macroeconomic impact in the form of lost national productivity

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