Background: The prevalence of type 2 diabetes (T2D) has increased rapidly over the last decades. The risks of complications and the medical consequences are well known, where hospital costs have been identified as a key driver of total costs. Less evidence has been generated on the impact of individual diabetic complications on the overall societal burden.
Objective: To analyse costs of hospital-based health care and of work absence related to individual microvascular and macrovascular complications of T2D in Sweden in 2016.
Method: The study used data from a Swedish retrospective observational database cross-linking 20 years of individual-level data (1997-2016) from national population-based health, social insurance and socio-economic registers for 392,200 people with T2D and matched controls (5:1). T2D status and presence of complications were derived from years 1997-2016 while the costs of hospital-based care and of production loss due to diabetes complications were estimated for 2016. Regression analysis was used for comparison to controls, to attribute production loss to individual complications, and to account for joint presence of complications.
Results: Hospital-based care costs were U.S. $622/person and production loss costs directly attributed to diabetes complications were U.S. $1,958/person in 2016. Additional costs were U.S. $523/person for early mortality in working ages and USD 377/person for medications in risk-factor treatment. Costs linked to angina pectoris and heart failure were key drivers of costs of macrovascular complications, and retinopathy and kidney disease of microvascular complications.
Conclusion: This study shows that the burden of complications in T2D is substantial. Costs of productivity loss were found to be greater than hospital-based care highlighting the need for considering outcomes beyond the health sector in treatment development and policy.
E. Andersson: Research Support; Self; Novo Nordisk A/S. S. Persson: Research Support; Self; Novo Nordisk A/S. N. Hallén: Employee; Self; Novo Nordisk A/S. Å. Ericsson: Employee; Self; Novo Nordisk Scandinavia AB. D. Thielke: Employee; Self; Novo Nordisk A/S. P. Lindgren: Research Support; Self; Novo Nordisk A/S. K. Steen Carlsson: Research Support; Self; Novo Nordisk A/S. J.H. Jendle: Advisory Panel; Self; Abbott, AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Medtronic, Novo Nordisk A/S, Sanofi. Research Support; Self; Novo Nordisk A/S. Speaker’s Bureau; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Novo Nordisk A/S, Sanofi.
Novo Nordisk A/S