Diabetes – Cost of Illness

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A recent study estimates the cost of diabetes on global scale by calculating the cost of treatment and loss of productivity across 184 countries.

 

The overall cost of an illness is comprised of direct and indirect costs. Direct costs include all expenses associated with the treatment of diabetes, such as medicines, hospital stays and other related costs. Indirect cost is calculated on the basis of productivity loss for the labor market resulting from sick days, premature morbidity and mortality.

Data from recent analysis by the IDF (International Diabetes Federation) estimates cost of diabetes to be in hundreds of billions of dollars per year (INT $670-825 billion). Indirect cost takes a large portion of estimated burden representing 28-82% of total cost.  Although this report estimates global cost, it doesn’t provide breakdown per region and does not take into account all labor market productivity loss for calculation of indirect costs. The biggest challenge is to compare cost of illness across different regions, due to variability in calculation methods and parameters included in total cost.

A study published in Lancet Diabetes & Endocrinology performed a systematic literature review to evaluate the cost of diabetes, including both direct and indirect components, and to draw comparisons between world regions and countries. Most attention was dedicated to the analysis of the labor market and illness-related loss of productivity, part of the indirect cost calculation.

Researchers considered the prevalence of diabetes and incidence of premature morbidity and mortality among adults between 20 and 79 years of age. For direct cost estimations, researchers calculated age-group specific and sex-specific expenditures for people with diabetes as compared to the same age/sex group without diabetes.  For labor market effects incorporated in indirect cost calculations, researchers included the cost of sick days, reduced productivity while working and premature dropout from the workforces due to disease.

The study estimates that the global economic burden of diabetes in 2015 was approximately US$1.31 trillion (95% CI) or 1.8% of the world GDP.  Notably, the indirect cost contributes as much as 34% of the total burden. The major contributors to indirect cost are dropout from workforce (48.5%) and mortality (45.5%). Notably, the contribution of mortality rates for indirect cost calculations are variable across countries, with 90% in low-income countries and only 35.5% in high-income countries. In high-income countries, morbidity-associated factors (dropout from workforce, low productivity) mostly contribute to indirect cost (59%), while these factors contribute only 7% in low-income countries.

Proportionally, North America has the highest economic burden, estimated at US $499 billion which translates to 2.6% of the total GDP, while sub-Saharan Africa is the least affected region (US$ 19 billion).

The findings suggest that although the direct cost of diabetes is important, the indirect cost shouldn’t be underestimated. The indirect cost poses an enormous economic burden and resources should be invested to reduce the costs. Investment in diabetes prevention and treatment would have an impact on direct and indirect costs. The economic burden of diabetes would decrease, as long as the investment expense is less than the revenue associated with production gain and other economic consequences they help to avoid.

 

Written By: Bella Groisman, PhD