Billion-Dollar Diabetes Burden Continues to Climb

Excess medical costs for diabetes and lost productivity amounted to more than $322 billion in 2012, a 48% increase from the $218 billion estimate for 2007, according to data published in the December 2014 issue of Diabetes Care.

Researchers from IHS Life Sciences expanded upon data published in 2010 in order to track trends in the economic burden of undiagnosed diabetes, prediabetes, and gestational diabetes mellitus (GDM) on a national and state level. The team analyzed medical claims for approximately 5 million commercially insured patients who were continually enrolled from 2010 to 2012, in addition to Medical Standard Analytical Files for approximately 2.6 million Medicare patients in 2011, and the 2010 Nationwide Inpatient Sample containing nearly 8 million hospital discharge records.

From 2007 to 2012, the researchers recorded a 48% increase in costs directly and indirectly related to diabetes. About $244 billion was related to excess medical costs — such as physician’s office and hospital visits, prescription drugs, and health conditions like hypertension and renal complications – and $78 billion was attributed to reduced productivity, which encompassed factors that reduced labor force participation.

During the same 5-year time period, the economic burden grew 40% for diagnosed diabetes, 82% for undiagnosed diabetes, 74% for prediabetes, and 103% for GDM.

“After adjusting for general inflation, this burden increased by >5% per year ($13.8 billion annually) due to increasing prevalence of disease and medical costs rising faster than general inflation,” the authors wrote. “The prevalence of diabetes is projected to grow substantially in the coming decades due to population growth, aging, and increasing racial and ethnic diversity, which portends large increases in the associated economic burden.”

The investigators noted the costs are disproportionally absorbed by diabetes patients and their caregivers, which can represent a hidden “tax” that averages $1000 per person in the form of higher medical insurance costs and reduced productivity. However, the data overstated medical costs that could be prevented, though the researchers noted htat not all diabetes cases can be prevented.

The authors provided a chart of their data broken down by state. In New Jersey, for example, 625,000 patients were diagnosed with diabetes in 2012, while an additional 235,000 had undiagnosed diabetes, nearly 2.5 million had prediabetes, and 5800 had GDM. This translated to $5.4 million, $698,000, $1.3 million, and $35,000 in related medical costs across the state, respectively.

“We believe that identifying prediabetes is worthwhile from both a clinical and a public health standpoint,” wrote Diabetes Care editor William T. Cefalu, MD, and others in an accompanying editorial. “The need to identify those with undiagnosed diabetes is even more pressing. The crisis is worsening. The time to act is now. These data clearly should signal a call for action.”