The Lewin Group, Optum Serve, Falls Church, VA.
American Diabetes Association, Arlington, VA.
Diabetes Care. 2024 Jan 1;47(1):26-43. doi: 10.2337/dci23-0085.
This study updates previous estimates of the economic burden of diagnosed diabetes, with calculation of the health resource use and indirect costs attributable to diabetes in 2022.
We combine the demographics of the U.S. population in 2022 with diabetes prevalence, from national survey data, epidemiological data, health care cost data, and economic data, into a Cost of Diabetes Economic Model to estimate the economic burden at the population and per capita levels. Health resource use and associated medical costs are analyzed by age, sex, race/ethnicity, comorbid condition, and health service category. Data sources include national surveys (2015-2020 or most recent available), Medicare standard analytic files (2020), and administrative claims data from 2018 to 2021 for a large commercially insured population in the U.S.
The total estimated cost of diagnosed diabetes in the U.S. in 2022 is $412.9 billion, including $306.6 billion in direct medical costs and $106.3 billion in indirect costs attributable to diabetes. For cost categories analyzed, care for people diagnosed with diabetes accounts for 1 in 4 health care dollars in the U.S., 61% of which are attributable to diabetes. On average people with diabetes incur annual medical expenditures of $19,736, of which approximately $12,022 is attributable to diabetes. People diagnosed with diabetes, on average, have medical expenditures 2.6 times higher than what would be expected without diabetes. Glucose-lowering medications and diabetes supplies account for ∼17% of the total direct medical costs attributable to diabetes. Major contributors to indirect costs are reduced employment due to disability ($28.3 billion), presenteeism ($35.8 billion), and lost productivity due to 338,526 premature deaths ($32.4 billion).
The inflation-adjusted direct medical costs of diabetes are estimated to rise 7% from 2017 and 35% from 2012 calculations (stated in 2022 dollars). Following decades of steadily increasing prevalence of diabetes, the overall estimated prevalence in 2022 remains relatively stable in comparison to 2017. However, the absolute number of people with diabetes has grown and contributes to increased health care expenditures, particularly per capita spending on inpatient hospital stays and prescription medications. The enormous economic toll of diabetes continues to burden society through direct medical and indirect costs.
本研究更新了以往对确诊糖尿病经济负担的估计,计算了 2022 年归因于糖尿病的卫生资源利用和间接成本。
我们将 2022 年美国人口的人口统计学数据与全国调查数据、流行病学数据、医疗保健成本数据和经济数据相结合,纳入一个糖尿病经济成本模型,以估计人群和人均水平的经济负担。按年龄、性别、种族/民族、合并症和卫生服务类别分析卫生资源利用和相关医疗费用。数据来源包括全国调查(2015-2020 年或最近可用)、医疗保险标准分析文件(2020 年)和 2018 年至 2021 年美国大型商业保险人群的行政索赔数据。
2022 年美国确诊糖尿病的总估计成本为 4129 亿美元,其中直接医疗费用 3066 亿美元,归因于糖尿病的间接费用 1063 亿美元。在所分析的费用类别中,用于治疗确诊糖尿病患者的费用占美国医疗保健支出的 1/4,其中 61%归因于糖尿病。平均而言,糖尿病患者每年的医疗支出为 19736 美元,其中约 12022 美元归因于糖尿病。确诊糖尿病患者的医疗支出平均是无糖尿病患者的 2.6 倍。降血糖药物和糖尿病用品占归因于糖尿病的总直接医疗费用的约 17%。间接费用的主要贡献者是残疾导致的就业减少(283 亿美元)、工作效率降低(358 亿美元)以及 338526 例过早死亡导致的生产力损失(324 亿美元)。
调整通货膨胀后,预计 2022 年糖尿病的直接医疗费用将比 2017 年上升 7%,比 2012 年的计算结果(以 2022 年美元计)上升 35%。在糖尿病患病率持续数十年稳步上升之后,2022 年的总体估计患病率与 2017 年相比相对稳定。然而,糖尿病患者的绝对人数有所增加,导致医疗支出增加,尤其是住院治疗和处方药的人均支出。直接医疗和间接成本继续给社会带来巨大的经济负担。