[Direct costs of ambulatory treatment of diabetes mellitus. Comparison of observed costs with estimated costs of adherence to the treatment standard].

BACKGROUND

The aim of this investigation was to record the observed direct costs of the outpatient treatment and therapy control of diabetic patients based on patient-related analysis of health care expenses in a population-based sample and to compare these costs with those generated if the minimum requirements of the European IDDM and NIDDM Policy Groups are fulfilled. Up to now there are only few studies on this topic.

PATIENTS AND METHOD

Medical records of a 5% random sample of all insured members of the AOK Dortmund (n = 6085) in 1990 provided the data basis. The direct diabetes-specific therapy and care costs were compiled per patient and year.

RESULTS

The annual costs for antidiabetic drugs, monitoring of blood glucose and glycated hemoglobin, test strips for self-monitoring, checking serum cholesterol, triglycerides and creatinine as well as for fundoscopy amounted to a mean of DM 1218.-per each insulin-treated patient (n = 65), DM 211.-per patient on oral antidiabetic drugs (OAD, n = 177), and DM 42.-per patient treated by diet alone (n = 108). Provided that the minimal recommendations of the European IDDM and NIDDM Policy Groups were followed the calculated costs would be DM 1758.-, DM 287.- and DM 198.-, respectively.

CONCLUSION

Fulfilling the minimum standards for diabetes care of the European IDDM and NIDDM Policy Groups, respectively, would cause additional costs per patient and year of DM 540.-for insulin-treated. of DM 76.-for OAD-treated and of DM 156.-for patients treated by diet alone. On the other hand adherence to the recommendations would reduce the annual costs for oral antidiabetic drugs by 40%. Improved care of diabetic patients would result in significantly higher costs, but these extra expenses would be probably compensated by a reduction or delay of late complication.