PDB56 ECONOMIC IMPACT OF TYPE 2 DIABETES AND DIABETES-ASSOCIATED COMPLICATIONS: A LARGE CLAIMS-BASED STUDY

Abstract

The chronic nature and complications of type 2 diabetes (T2DM) impose a large economic burden on society. Our aim was to provide reliable estimates of direct costs associated with the management of T2DM and its complications in the Czech Republic. A retrospective prevalence-based cost-of-illness study analysed health insurance claims for years 2013-2017 provided by the second largest health insurance fund in the Czech Republic (1,307,000 insured, i.e. 12.5 % of the Czech population). The selection of diabetic patients was defined by ICD-10 diagnose E11 recorded at least twice and at least one prescription of antidiabetics (ATC A10). The overall sample size consisted of 62,895 patients with T2DM. Out of the total patient population, 52% had no complications, 22% only microvascular, 13% only macrovascular and 14% both micro- and macrovascular complications. From a health-care payer perspective, there was a steady increase in the mean total costs per diabetic patient per year (pppy), from €878 in 2013 to €1,264 in 2017 (+44%). In 2013, medicines were the major contributor to direct costs (56%). However, this proportion gradually declined until it reached 49% in 2017. Other main drivers of costs were hospital care (14%), medical devices (8%) and outpatient care (7%). The mean total direct costs pppy were 1) €656 (without complications; denoted as baseline), 2) €1,058 (microvascular complications; +61% relative to baseline costs without complications), 3) €1,281 (macrovascular complications; +95%) 4) €2,025 (micro- and macrovascular complications; +209%). Results suggest that the costs of T2DM are substantial and are growing both over time and with associated complications. To our knowledge, this is the first Czech study providing contemporary real-world evidence on the average diabetic patient costs and associated complications. Our estimates may support health care stakeholders in evaluating the optimal resource allocation across different prevention and intervention programs.