Abstract
Introduction: Structured diabetes care programs in Argentina are scarce and do not inform about their cost using micro costing techniques. Aim: To estimate the incremental costs of a health care program for type 2 diabetes without complications implemented at sub-national level in Argentina during 2005. Methods: United Kingdom Prospective Diabetes Study and Latin American Diabetes Association guidelines were used to identify which resources should be part of a diabetes program to implement in two Argentinean provinces – Cordoba and Misiones – with high and low socioeconomic characteristics, respectively. A micro costing approach was used to estimate costs from the perspective of a public health payer, taking a province without diabetes program as a comparative scenario. Probabilistic sensitivity analysis following Monte Carlo simulation was used to determine the number of visits and practices, probability of insulin treatment, combination therapy for hypertension, annual number of test strips and unit cost of all resources used. Results: The main component of the annual incremental cost per patient in both provinces was self-monitoring blood glucose (~50%), followed by treatment of diabetes, dyslipidemia and hypertension. The lowest cost corresponded to human resources ( 90%). Discussion: This study provides original evidence for Argentina that could facilitate the development and further evaluation of diabetes programs and resource use optimization in the public health care subsector in other provinces/ countries with comparable socioeconomic and health care settings.
Highlights
Structured diabetes care programs in Argentina are scarce and do not inform about their cost using micro costing techniques
This study provides original evidence for Argentina that could facilitate the development and further evaluation of diabetes programs and resource use optimization in the public health care subsector in other provinces/ countries with comparable socioeconomic and health care settings
International reports show that an important economic investment is required for the implementation of diabetes care programs
Summary
Structured diabetes care programs in Argentina are scarce and do not inform about their cost using micro costing techniques. The continuously increasing prevalence of diabetes worldwide and of the associated invalidating complications in people with poor disease control represent a serious problem for health care systems and for society [1,2]. This situation can be alleviated through the implementation of structured health care programs for diabetes and its associated cardiovascular risk factors, that facilitate patient access to appropriate care and treatment.. To cope with the care demand, almost all the Argentinean provinces have implemented diabetes programs with different degree of treatment provision/ coverage Their general objectives are in line with those formulated at national level: prevention, promotion, training, health care coverage, and provision of drugs and supplies for control and treatment
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