Metabolism and Diabetes Unit ASL Turin 5, Chieri, Italy.
Expert Rev Pharmacoecon Outcomes Res. 2011 Dec;11(6):709-19. doi: 10.1586/erp.11.78.
Diabetes mellitus is an increasingly common chronic disease that has a great impact not only in terms of clinical effects, but also in terms of economic burden worldwide. Expenditures due to diabetes derive essentially from direct and indirect costs. Current estimates of global healthcare expenditures due to diabetes are US$376 billion and are expected to increase to US$490 billion by 2030. In particular, costs associated with diabetes-related complications represent the most relevant part of the national healthcare expenditure for diabetes and are higher than the costs of managing diabetes itself. The major expenditure depends on the type and the number of complications: cardiovascular complications increase direct costs, especially for hospitalization. Moreover, diabetic comorbidity has a greater economic impact on the health expenditure in comparison with those patients without diabetes. In Europe, the CODE-2 study was the first attempt to evaluate the costs of diabetes: the annual costs per patient were estimated at €2384 and the highest value, €2991, was registered in Italy. This indicates an overall annual cost of €5170 million for the whole Italian population with diabetes. Current estimates for 2010 healthcare expenditure for diabetes are US$105 billion (10% of total healthcare expenditure, US$2046 per person) for the whole European region, and US$11 billion (9% of total healthcare expenditure, US$2087 per person) for Italy. More studies are needed in order to better define the real significance of the healthcare costs of diabetes in Italy. An effective therapy with a good metabolic control can reduce the risk of complications and represents a valid strategy from an economic point of view.
糖尿病是一种日益常见的慢性病，不仅在临床效果方面，而且在全球经济负担方面都有很大的影响。糖尿病的支出主要来自直接成本和间接成本。目前全球因糖尿病导致的医疗保健支出估计为 3760 亿美元，预计到 2030 年将增至 4900 亿美元。特别是，与糖尿病相关并发症相关的成本占糖尿病国家医疗保健支出的最重要部分，高于管理糖尿病本身的成本。主要支出取决于并发症的类型和数量：心血管并发症增加直接成本，尤其是住院治疗。此外，与没有糖尿病的患者相比，糖尿病合并症对医疗保健支出的经济影响更大。在欧洲，CODE-2 研究首次尝试评估糖尿病的成本：估计每位患者的年成本为 2384 欧元，意大利的最高值为 2991 欧元。这表明整个意大利糖尿病患者的年总支出为 5.17 亿欧元。目前对整个欧洲地区 2010 年糖尿病医疗保健支出的估计为 1050 亿美元（占总医疗保健支出的 10%，每人 2046 美元），意大利为 110 亿美元（占总医疗保健支出的 9%，每人 2087 美元）。需要进行更多的研究，以更好地确定意大利糖尿病医疗保健成本的真正意义。有效的治疗方法和良好的代谢控制可以降低并发症的风险，从经济角度来看是一种有效的策略。
