Abstract
Aim: The objective is to contribute with real world evidenced economic forecasts of diabetes attributable costs in 2025 and 2040 differentiated according to patients’ morbidity status which is a novel approach within forecasting. Methods: Method of forecasting is based on an annual calendar year prediction of diabetes attributable costs by using the BOX-model, an established and tested epidemiological transition-state model. The study population includes all Danish diabetes patients presented in 2011 (N = 318,729) according to the Danish National Diabetes Register. Forecasting is based on individual patient data from 2000 to 2011 for incidence, mortality, patterns of morbidity and complication rates combined with demographic population projections from Statistics Denmark. The 2011 estimation of diabetes attributable costs were applied to the epidemiological framework. Forecasting was performed for three different epidemiological scenarios. Results: Our three epidemiological scenarios indicate that within the shorter time span increases in the prevalent population are difficult to change primarily due to the already achieved historic improvements in diabetes mortality and morbidity. These will approximately double societal costs of diabetes in the next 10 years assuming current trends in morbidity and mortality are maintained. The resulting diabetes population will incur three times current costs in 2040. A 20% reduction in cost per PYRS shows how the relative distribution of patients with complications is expected to change over time with patients living better with their disease and hence incur a lower demand for health and nursing care services.
Highlights
Chronic diseases are one of this century’s greatest threats towards public health with almost epidemic prevalence increases globally and expectations of significant increases in the future [1]
Diabetes Mellitus is, with around 350 million people globally suffering from this disease [2] [3], one of the most burdensome chronic diseases associated with major disability, reduced quality of life and shortened length of life [2] [4]
The diabetes-free population, and population time at risk of developing diabetes, for each calendar year until 2040 was calculated from demographic population projections from Statistics Denmark based on recent trends for vital demographic events: birth rate, death rate, immigration, emigration and naturalization, converging towards a long time perspective level based on annual forecasts [29]
Summary
Chronic diseases are one of this century’s greatest threats towards public health with almost epidemic prevalence increases globally and expectations of significant increases in the future [1]. Management of the increasing diabetes population implies, among others, an economic challenge, which societies must face, as diabetes patients require increased health care, pharmaceuticals and nursing services for their remaining lifetime[4] [15] [16]. Our forecasting model (the BOX-model) is an established and tested epidemiological disease model, which has proven its global applicability for different diseases with largely accurate predictions showing only nonessential deviations[9] [23] [24]. The BOX-model is simple and intuitive, based on epidemiological drivers observed over more than a decade and economic cost estimates for 2011 calculated on the individual level from national registers
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