Direct Cost of Diabetes Has Doubled Since 1997
The annual direct cost of diabetes in the United
States more than doubled between 1997 and 2002,
Tommy G. Thompson also announced there are over
17 million people with diabetes and another 16
million with PreDiabetes at a press briefing.
In a cost survey conducted by the Lewin Group for
the American Diabetes Association (ADA), annual direct
diabetes-related medical costs rose from $44 billion
in 1997 to $91.8 billion in 2002. Total costs, which
factor in lost productivity, were $132 billion in
2002, up from $98 billion in 1997 (Diabetes Care
26[3]:917-32, 2003).
“This study reveals the staggering burden
of diabetes upon our society,” Mr. Thompson
said, noting that nearly 17 million Americans—or
1 in 20—now have type 2 diabetes. And at least
16 million more have “prediabetes,” a
term introduced last year by federal health officials
and the ADA to denote individuals at high risk for
developing the disease.
“Even more frightening, about one-third of
the 17 million don't know they have diabetes, so
the true cost is probably much higher than the $132
billion,” he said.
The study, which used data from several sources,
was funded by the ADA, the National Institute of
Diabetes and Digestive and Kidney Diseases, and at
least 15 manufacturers of diabetes medications and
supplies.
The $92
billion figure was derived from the excess costs
incurred by people with diabetes above what
would be expected from a nondiabetic population.
Of that total, 25% ($23 billion) was for diabetes
costs alone, 27% ($25 billion) was for treatment
of seven major diabetes-related complications (including
cardiovascular, neurologic, peripheral vascular,
renal, and ophthalmic conditions), and 48% ($44 billion)
was for other “general medical conditions” among
patients with diabetes.
Inpatient (hospital and nursing home) costs comprised
41% of the total; outpatient care, 15%; and outpatient
medication and supplies, 13%.
According to the ADA, projections from U.S. Census
data suggest that the national cost of diabetes could
grow to $156 billion by 2010 (in 2002 dollars) and
to $192 billion by 2020. The figure for 2020 includes
$138 billion for direct medical costs and $54 billion
for indirect costs due to lost productivity. The
actual cost could be even higher if the prevalence
of diabetes continues to grow along with the prevalence
of obesity, the ADA noted in the published article.
But Mr.
Thompson is determined to prevent that from happening. “I personally, absolutely refuse
to accept the spread of diabetes. … Type 2
diabetes is a preventable disease,” he said,
describing several federal initiatives that are now
aimed at reversing the current trends.
The National
Diabetes Education Program (www.ndep.nih.gov),
has launched “Small Steps, Big Rewards,” a
program aimed at translating the results of last
year's landmark Diabetes Prevention Program trial
for use by health care providers and the public.
The study found that relatively small increases in
physical activity and moderate weight loss can prevent
type 2 diabetes (N. Engl. J. Med 346[6]:393-403,
2002).
The HHS
is seeking proposals for 3-year capitated disease
management demonstration projects. Under
the auspices of the Centers for Medicare and Medicaid
Services, health care organizations will receive
funding to offer tailored health plans for Medicare
beneficiaries with chronic conditions such as diabetes,
stroke, or congestive heart failure. “Providers
will now have a financial interest in the health
of their patients, not the quantity of their services,” Mr.
Thompson said.
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DO YOU KNOW
A study published this week in Heart, a British medical
journal, found that only vigorous exercise -- such
as jogging, hiking, climbing stairs, racket sports
and swimming -- seems to help lower the risk of early
death from heart disease. Other research has shown
moderate exercise helps.
.
