The cost of health care for diabetics is $105 billion dollars a year, more than double the $45 billion previously estimated, according to a 1992 study published in the Journal of Clinical Endocrinology and Metabolism (1).
The study looked at all health care costs for people with diabetes, whether the patients saw the doctor for diabetes-induced kidney failure or for probably unrelated heart surgery. The reason? Diabetes is a chronic illness that in some way affects almost every part of the body, so diabetics often suffer more than other people from the same illnesses.
"The costs were 3 1/2 times as much for diabetics even if they weren't in the hospital for direct complications of the diabetes," said Bob Stone of the Diabetes Treatment Centers of America, which funded the study. "Nobody had ever asked that question before." The American Diabetes Association last year estimated the direct medical costs of diabetes at $45.2 billion. That included the cost of blood-sugar tests and insulin as well as kidney failure, retinopathy and other diabetes-caused illnesses. The American Diabetes Association said the indirect costs of diabetes, such as lost productivity and premature death, equal $46.6 billion. The discrepancy is partly explained by the new study's conclusion that 3.1 percent of the U.S. population has diabetes, compared with the American Diabetes Association's estimate of 2.7 percent.
But whether one counts only diabetes-induced doctor visits or every case of bronchitis, "we're both making the same point, which is that people with diabetes need to get better care. That will cut the health care costs," said an association spokeswoman. The study, by the Fairfax, Va., consulting firm Lewin-VHI Inc., compared yearly medical expenditures of 1,620 diabetics with those of non-diabetics, looking at everything from hospitalization or a doctor's office visit to prescription drugs and dental work. In each case except dentist visits the diabetics had higher costs. Individual diabetics spent an average of $9,493 on health care in 1992, the latest data available, compared with $2,604 for people without diabetes, the study said.
The study also found that care for diabetics constituted 14.6 percent of the $720.5 billion spent on health care in 1992, or about one in every seven dollars. Diabetes Treatment Centers, which operate 70 hospital-based diabetes centers around the country, said the study emphasizes the importance of new treatment guidelines for the disease.
Last summer [1993], the National Institutes of Health [in the DCCT study] proved that patients who rigorously maintained blood-sugar levels as close as possible to normal significantly slowed the disease. That study recommended frequent use of a simple laboratory test [called glycohemoglobin] that measures average blood-sugar levels over the previous 90 days, letting doctors see whether their patients' treatment works well enough. Stone on Tuesday said wider use of that test would help bring down diabetes costs almost immediately.
(1) Rubin RJ, Altman WM, Mendelson DN. J Clin Endocrinol Metab 1994 Apr;78(4):809A-809F, Health care expenditures for people with diabetes mellitus, 1992. An abstract of this article can be found at PubMed.
Also see
What are the Costs of Diabetes Mellitus? (a slide show about the costs of diabetes, at the DiabetesMonitor)
Economic evaluation in diabetes Evaluative Studies of Diabetes-Related Issues in the Literature. Thomas Songer, PhD Dept. of Epidemiology, University of Pittsburgh
