Medical and economic case for prevention of type 2 diabetes and cardiovascular disease

Abstract

A convincing medical and economic case exists for implementing broad public health strategies aimed at preventing type 2 diabetes and cardiovascular disease in those with the metabolic syndrome. Quantification of the economic case for prevention already exists, and new work further elucidates the economic gains resulting from both primary and secondary prevention. There are two key cost of illness studies for diabetes in Europe: CODE-2 (Cost of Diabetes in Europe—Type 2), which looked at the direct healthcare costs in eight European countries and T2ARDIS (Type 2 Diabetes Accounting for Major Resources Demand in Society), which examined the direct and indirect costs of type 2 diabetes in the UK.1–3 Although these studies are already dated, they both have messages which are still relevant and pertinent to the cost of illness and cost effectiveness. ### CODE-2 study The CODE-2 study attempted, for the first time, to quantify the direct healthcare cost of type 2 diabetes in eight European countries, using the same protocol. The study investigated the total annual direct medical costs for patients with type 2 diabetes in each country. The countries involved were Belgium, France, Germany, Italy, The Netherlands, Spain, Sweden, and the UK. Type 2 diabetes was defined as diabetes not treated by insulin at onset and which occurred in people ≥30 years of age. Over 700 people were identified according to these criteria in samples identified in each of the eight countries. The study looked retrospectively at the records for the year 1998 to identify all of the patients' contacts with health services. Country-specific unit cost estimates were used for the cost of an outpatient appointment, an inpatient appointment, and so on. The total cost for type 2 diabetes for all eight countries in 1998 was 29 billion Euros. This information is, of course, now out …