Productivity and Medical Costs of Diabetes in a Large Employer Population

  1. Scott Ramsey, MD, PHD1,
  2. Kent H. Summers, PHD2,
  3. Stephanie A. Leong, MPP 3,
  4. Howard G. Birnbaum, PHD3,
  5. Jason E. Kemner, MPH2 and
  6. Paul Greenberg, MA3
  1. 1Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington
  2. 2Eli Lilly, Indianapolis, Indiana
  3. 3Analysis Group/Economics, Cambridge, Massachusetts


    OBJECTIVE—The purpose of this study was to assess the economic burden of diabetes from an employer’s perspective. We analyzed the costs of diabetes, using claims data for an employed population and the prevalence of selected comorbid conditions.

    RESEARCH DESIGN AND METHODS—The data source is a claims database from a national Fortune 100 manufacturer. It includes medical, pharmacy, and disability claims for all beneficiaries (n >100,000). Both medical and work productivity costs of diabetes patients are compared by age with those of matched control subjects from the overall beneficiary population. Out-of-pocket and intangible costs are excluded.

    RESULTS—In 1998, the employer’s mean annual per capita costs were higher for all diabetes beneficiaries than for control subjects ($7,778 ± 16,176 vs. $3,367 ± 8,783; P < 0.0001), yielding an incremental cost of $4,410 ± 18,407 associated with diabetes. The medical and productivity costs for employees with diabetes were significantly (P < 0.0008) higher than for control subjects. The incremental cost of diabetes among employees ranged from $4,671 (aged 18–35 years) to $4,369 (aged 56–64 years).

    CONCLUSIONS—Diabetes imposes a significant economic burden on employers, particularly when including productivity costs. Employers should select health plans that provide enriched benefits to diabetes patients, including ready access to medical and pharmacy services as well as aggressive diabetes management programs.


    • Address correspondence and reprint requests to Kent H. Summers, Lilly Corporate Center, Indianapolis, IN 46285. E-mail: summers_kent_h{at}

      Received for publication 18 June 2001 and accepted in revised form 10 October 2001.

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