Predictive Model for Estimating the Cost of Incident Diabetes Complications.

Abstract

The cost of diabetes care accounts for a significant proportion of healthcare expenditures. Cost models based on updated incident complication rates and associated costs are needed to improve financial planning and quality assessment across the U.S. healthcare system. We developed a cost model using published data to estimate the direct medical costs of incident diabetes-related complications in a U.S. population of adults. A systematic literature review of MEDLINE, EMBASE, and TRIP databases was conducted on studies reporting the incidence and/or cost of diabetes-related complications (cardiovascular disease, neuropathy, nephropathy, ophthalmological disease, and acute metabolic events). A total of 54 studies met eligibility criteria. A baseline model was constructed for a U.S. population with type 1 and 2 diabetes mellitus and used to determine the expected costs of managing such a population over 1-, 3-, and 5-year time horizons. The most costly incident complications in a population of 10,000 adults with diabetes were (1) congestive heart failure (CHF): annual expected cost of $7,320,287, 5-year expected cost of $50,697,865; (2) end-stage renal disease (ESRD): annual expected cost of $4,225,384, 5-year expected cost of $13,211,204; and (3) gangrene: annual expected cost of $2,844,381, 5-year expected cost of $17,200,417. This cost model estimates the direct healthcare costs of incident diabetes-related complications in a U.S. adult population with diabetes and provides a benchmark for evaluating the cost-effectiveness and potential leakage within a care delivery network.