Prevalence and direct medical costs of end-stage renal disease in patients with type 2 diabetes mellitus in Switzerland for 2001.

Abstract

The prevalence of end-stage renal disease (ESRD) in patients with type 2 diabetes mellitus (type 2 DM) has increased in recent decades throughout the world. In most industrialised countries, diabetic nephropathy in type 2 diabetics is the most frequent cause of ESRD. The prevalence and direct medical costs for the insurance funds in Switzerland were determined for ESRD in patients with type 2 DM. Prevalence was determined on the basis of a written retrospective cross-sectional analysis covering all centres for dialysis and transplantation in Switzerland. Costs were calculated separately for the three different therapeutic options for ESRD - haemodialysis, peritoneal dialysis and renal transplantation. Costs were calculated on the basis of the percentage of the patients in this cross-sectional study who received each of these treatments. Cost data from the Swiss Union for the Social Duties of the Insurance Funds (SVK) were used for all three treatments. SVK data were not available for some phases of transplantation, and for these phases the consumption of health resources was determined by interviewing experts on the telephone, using a questionnaire. The cross-sectional study in the dialysis and transplantation centres was based on full collection of data. In Switzerland in the year 2001, the prevalence of ESRD in patients with type 2 DM came to 73.0 per million inhabitants. The direct medical costs of this complication came to a total of CHF 46,065,788 (0.1% of the total health expenditure). This corresponds to CHF 1570 per 100,000 inhabitants per day. 81.6% of these costs are for haemodialysis, 7.1% for peritoneal dialysis and 11.4% for renal transplantation. ESRD costs are CHF 215 per patient per day. The prevalence of ESRD in patients with type 2 DM in Switzerland was 73.0 per million inhabitants in 2001. The costs of this avoidable late complication are considerable.