Societal costs of diabetes mellitus in Denmark

Abstract

Aim: To provide comprehensive real-world evidence on societal diabetes-attributable costs in Denmark.

Methods: National register data are linked on an individual level through unique central personal registration numbers in Denmark. All patients in the Danish National Diabetes Register in 2011 (N = 318 729) were included in this study. Complication status was defined according to data from the Danish National Hospital Register. Diabetes-attributable costs were calculated as the difference between costs of patients with diabetes and the expected costs given the annual resource consumption of the diabetes-free population.

Results: Societal costs attributable to diabetes were estimated to be at least 4.27 billion EUR in 2011, corresponding to 14,349 EUR per patient-year. A twofold higher healthcare resource usage was found for patients with diabetes as compared with the diabetes-free population. Attributable costs, grouped according to different components, were 732 million EUR for primary and secondary care services, 153 million EUR for pharmaceutical drugs, 851 million EUR for nursing services, 1.77 billion EUR in lost productivity and 761 million EUR for additional costs. A steep increase in diabetes-attributable costs was found for patients with major complications compared with patients without complications across all cost components. For attributable healthcare costs this increase was estimated to be 6,992 EUR per person-year after controlling for potential confounders.

Conclusions: Nearly half of the total costs of patients with diabetes can be attributed directly to their diabetes. The majority of costs are incurred among patients with major complications pointing to the importance of secondary preventive efforts among patients with diabetes.

Figure 1

Total cost of secondary care for the diabetes‐free population (DKnoDM) and patients with diabetes (DM) by complication state (C0: no, C1: minor and C2: major) for (a) women and (b) men.

Figure 2

Diabetes‐attributable cost for pharmaceuticals by age, gender and complication status (C0: no, C1: minor and C2: major).

Figure 3

Annual difference in mean gross income according to age and education level for (a) women and (b) men with no diabetes complications.

Figure 4

Relative distribution of the components of diabetes‐attributable costs.

Figure 5

Diabetes attributable costs according to complication status (C0: no complications; C1: minor complications; C2: major complications) and gender.

Figure 6

Relative distribution of person years (a) and diabetes attributable costs (b) according to complication status (C0: no complications; C1: minor complications; C2: major complications).