Charbonnel Bernard, Simon Dominique, Dallongeville Jean, Bureau Isabelle, Dejager Sylvie, Levy-Bachelot Laurie, Gourmelen Julie, Detournay Bruno
Hôtel Dieu Hospital, Nantes, France.
Diabetes Department and ICAN (Institute of Cardiometabolism And Nutrition), Pitié Hospital, Paris, France.
Pharmacoecon Open. 2018 Jun;2(2):209-219. doi: 10.1007/s41669-017-0050-3.
Our objects was to estimate the direct healthcare costs of type 2 diabetes mellitus (T2DM) in France in 2013.
Data were drawn from a random sample of ≈600,000 patients registered in the French national health insurances database, which covers 90% of the French population. An algorithm was used to select patients with T2DM. Direct healthcare costs from a collective perspective were derived from the database and compared with those from a control group to estimate the cost of diabetes and related comorbidities. Overall direct costs were also compared according to the diabetes therapies used throughout the year 2013.
Cost analysis was available for a sample of 25,987 patients with T2DM (mean age 67.5 ± standard deviation 12.5; 53.9% male) matched with a control group of 76,406 individuals without diabetes. Overall per patient per year medical expenditures were €6506 ± 10,106 in the T2DM group as compared with €3668 ± 6954 in the control group. The cost difference between the two groups was €2838 per patient per year, mainly due to hospitalizations, medication and nursing care costs. Total per capita annual costs were lowest for patients receiving metformin monotherapy (€4153 ± 6170) and highest for those receiving insulin (€12,890). However, apart from patients receiving insulin, costs did not differ markedly across the different oral treatment patterns.
Extrapolating these results to the whole T2DM population in France, total direct costs of diagnosed T2DM in 2013 was estimated at over €8.5 billion. This estimate highlights the substantial economic burden of this condition on society.
我们的目标是估算2013年法国2型糖尿病（T2DM）的直接医疗费用。
数据取自法国国家医疗保险数据库中约600,000名登记患者的随机样本，该数据库覆盖了90%的法国人口。使用一种算法来选择T2DM患者。从总体角度得出的直接医疗费用来自该数据库，并与对照组的费用进行比较，以估算糖尿病及相关合并症的费用。还根据2013年全年使用的糖尿病治疗方法对总体直接费用进行了比较。
对25,987名T2DM患者（平均年龄67.5±标准差12.5；男性占53.9%）的样本进行了成本分析，并与76,406名无糖尿病个体的对照组进行了匹配。T2DM组每位患者每年的总体医疗支出为6506±10,106欧元，而对照组为3668±6954欧元。两组之间的费用差异为每位患者每年2838欧元，主要是由于住院、药物和护理费用。接受二甲双胍单药治疗的患者人均年度总费用最低（4153±6170欧元），接受胰岛素治疗的患者最高（12,890欧元）。然而，除了接受胰岛素治疗的患者外，不同口服治疗模式的费用差异并不明显。
将这些结果推算至法国整个T2DM人群中，可以估计2013年确诊的T2DM的总直接费用超过85亿欧元。这一估计凸显了这种疾病给社会带来的巨大经济负担。
