Costs of treatment and complications of adult type 1 diabetes

• Published in: Nutrition, metabolism, and cardiovascular diseases Vol. 23; no. 7; pp. 606 - 611
• Main Authors: Franciosi, M, Lucisano, G, Amoretti, R, Capani, F, Bruttomesso, D, Di Bartolo, P, Girelli, A, Leonetti, F, Morviducci, L, Vitacolonna, E, Nicolucci, A
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.07.2013
• Subjects: Adolescent; Adult; Adult patients; adults; blood glucose; Blood Glucose Self-Monitoring - economics; Cardiovascular; Case-Control Studies; Complication of diabetes; confidence interval; Cost analysis; Cost of Illness; Costs and Cost Analysis; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - drug therapy; Diabetes Mellitus, Type 1 - economics; Diabetic Angiopathies - economics; Diabetic Angiopathies - prevention & control; Diabetic Angiopathies - therapy; diagnostic techniques; Direct costs; disease control; Drug Costs; drugs; Female; Health Care Costs; Health Care Surveys; Humans; Hypoglycemic Agents - administration & dosage; Hypoglycemic Agents - economics; Hypoglycemic Agents - therapeutic use; insulin; Insulin - administration & dosage; Insulin - economics; Insulin - therapeutic use; Insulin Infusion Systems - economics; insulin-dependent diabetes mellitus; Italy; Male; Middle Aged; multivariate analysis; patients; Poisson Distribution; quality of life; questionnaires; regression analysis; Retrospective Studies; surveys; therapeutics; Treatment costs; Type 1 diabetes; women; Young Adult; Italy; Complication of diabetes; Cost analysis; Type 1 diabetes; Direct costs; Adult patients; Treatment costs
• ISSN: 0939-4753; 1590-3729
• DOI: 10.1016/j.numecd.2012.03.002

Abstract Background and aims Costs associated with diabetes represent a large burden for patients and the health-care system. However, few studies examined the costs for diabetes treatment in adults with type 1 diabetes (T1DM). This analysis was aimed to assess the costs of treatment associated with T1DM among adults in Italy from the national health-care system perspective. Methods and results Data were collected using a questionnaire assessing resource consumption retrospectively (drugs, visits, diagnostics, hospitalisations and self-monitoring of blood glucose (SMBG)). One-year costs were calculated for the 12 months preceding the survey. Cost estimation, referred to 2006, was carried out using univariate and multivariate Poisson regression models. Fifty-eight centres enrolled 1193 patients (49.5% women; aged between 18 and 55 years, average diabetes duration was 16.1 ± 9.8 years). The average annual cost for an adult patient with TDM1 was €2450 (95% confidence interval (CI): 2358–2544). Insulin therapy and SMBG accounted together for 71.2% of total costs (35.6% and 35.6%, respectively); the remainder was shared by hospitalisations (18%), visits (4.0%), diagnostics (3.9%) and other drugs (2.9%). Univariate analyses showed that the presence of complications was associated with excess of costs, mainly related to the hospitalisation and drugs. Multivariate analyses confirmed these results showing that the presence of micro-vascular plus macrovascular complications doubles the cost of treatment. Conclusion Strategies of care for T1DM that can improve disease management and prevent or delay the onset of complications could represent the most important tool to reduce costs in the long term while improving clinical outcomes and quality of life.