Diabetes Atlas
Global healthcare expenditure on diabetes for 2010 and 2030

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Abstract

Aims

To estimate the global health expenditure on diabetes among people aged 20–79 years for the years 2010 and 2030.

Methods

Country-by-country expenditures for 193 countries, expressed in United States Dollars (USD) and in International Dollars (ID), were estimated based on the country's age–sex specific diabetes prevalence and population estimates, per capita health expenditures, and health expenditure ratios per person with and without diabetes. Diabetes prevalence was estimated from studies in 91 countries. Population estimates and health expenditures were from the United Nations and the World Health Organization. The health expenditure ratios were estimated based on utilization and cost data of a large health plan in the U.S. Diabetes expenditures for the year 2030 were projected by considering future changes in demographics and urbanization.

Results

The global health expenditure on diabetes is expected to total at least USD 376 billion or ID 418 billion in 2010 and USD 490 billion or ID 561 billion in 2030. Globally, 12% of the health expenditures and USD 1330 (ID 1478) per person are anticipated to be spent on diabetes in 2010. The expenditure varies by region, age group, gender, and country's income level.

Conclusions

Diabetes imposes an increasing economic burden on national health care systems worldwide. More prevention efforts are needed to reduce this burden. Meanwhile, the very low expenditures per capita in poor countries indicate that more resources are required to provide basic diabetes care in such settings.

Introduction

Diabetes is a common chronic disease in nearly all countries. There are an estimated 285 billion adults with diabetes in 2010; this number will continue to increase globally due to an aging population, growth of population size, urbanization and high prevalences of obesity and sedentary lifestyle [1]. Diabetes leads to both premature death and complications such as blindness, amputations, renal disease, and cardiovascular diseases.

Diabetes is also costly to health care systems. People with diabetes have more outpatient visits, use more medications, have a higher probability of being hospitalized, and are more likely to require emergency and long-term care than people without the disease. In the United States, people with diabetes, on average, spent 2.5 times more on medical care than people without the condition [2]. Estimates of the current and future economic burden on the health care system can assist decision-makers understand the magnitude of the problem, prioritize research efforts, and plan resource allocation to properly manage the condition. Disease cost estimates also help prioritize interventions, which must be done in the face of limited health care resources.

The global health care expenditure attributable to diabetes has been estimated in 2003 and 2006 by the International Diabetes Federation (IDF) and reported in the second and third editions of the Diabetes Atlas [3], [4]. While the basic approach used to derive such estimates in the current study and the two previous studies are the same, we improved the previous estimates in two ways. Compared with the analysis in the second edition of the Diabetes Atlas, which used a single health expenditure ratio (a critical input parameter for the expenditure model) per person with and without diabetes, we used age–sex specific expenditure ratios. Using age–sex specific expenditure ratios can account for differences in the age–sex structures of the populations across countries. Compared with the analysis in the third edition of the Diabetes Atlas, we update the expenditure estimates using the improved diabetes prevalence data and the latest available estimates on each country's demographics, and health expenditure. The purpose of our study was to provide estimates on health expenditures attributable to diabetes for all countries of the United Nations for the years 2010 and 2030.

Section snippets

Methods and data

The global health expenditure attributable to diabetes is the sum of the expenditure of 193 individual countries. The expenditures of 23 countries or regions that were members of United Nations but with no appropriate health expenditure data available were not accounted to in the sum; these 23 countries or regions account for less than 2% of the world population. We also grouped the expenditure for diabetes into regions using two different definitions: the IDF membership regions (Sub-Saharan

Health expenditures for diabetes in 2010

The total annual global health expenditure for diabetes in 2010 is estimated to fall between USD 376.0 billion (R = 2) and USD 672.2 billion (R = 3), or between ID 417.8 billion and ID 745.7 billion (Table 1). Expenditure on diabetes is expected to account for 12% (R = 2) of the world's total health expenditure (Table 1). On average, USD 1330 (R = 2) is expected to be spent on each person with diabetes (Table 1).

Spending on diabetes varies by IDF region. The NA region will spend USD 214.2 billion, or

Discussion

We estimated that the global health expenditure on diabetes is expected to total at least USD 376 billion or ID 418 billion or 12% of the total health expenditure in 2010. On average, USD 1330 is being spent on each person with diabetes. About 80% of the countries will spend 5–13% of their national health expenditures on diabetes. These results suggest diabetes imposes a large economic burden on the national health care system worldwide, thus more prevention efforts are needed to reduce this

Declaimer

The contents of this paper are solely the responsibility of the authors and do not necessarily represent the official positions of the Centers for Disease Control and Prevention.

Conflict of interest

There are no conflicts of interest.

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