The Economic Cost of Diabetes in Canada, 1998
- Keith G. Dawson, MD, PHD1,
- Daniel Gomes, MSC2,
- Hertzel Gerstein, MD, MSC3,
- James F. Blanchard, MD, PHD4 and
- Kristijan H. Kahler, RPH, MSC2
- 1Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- 2Merck, Whitehouse Station, New Jersey
- 3Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- 4Department of Community Health Services, University of Manitoba, Winnipeg, Manitoba, Canada
Abstract
OBJECTIVE—In Canada, diabetes poses a significant health problem, and current estimates of its economic burden have not incorporated the total cost of the disease. The objective of this study was to quantify the direct medical- and mortality-related productivity cost of diabetes in Canada for 1998.
RESEARCH DESIGN AND METHODS—Direct medical costs included hospital services, physician services, and medicines consumed by people with diabetes. These costs were based on a top-down costing methodology that allocated 1998 total medical expenditures to diabetes. The prevalence of diagnosed and undiagnosed diabetes and the relative risk of complications in people with diabetes were used to estimate the proportion of medical services that were consumed by people with diabetes. Mortality-related productivity losses were calculated using the human capital approach.
RESULTS—After varying the assumptions in a sensitivity analysis, the total economic burden (in U.S. dollars) of diabetes and its chronic complications in Canada for 1998 was likely to be between $4.76 and $5.23 billion. In those people just with diagnosed diabetes, the direct medical costs associated with diabetes care, before considering any complications, were $573 million. Of the costs associated with the complications of diabetes, cardiovascular disease was by far the greatest, at $637 million.
CONCLUSIONS—Cardiovascular disease was the major contributor to the direct costs of diabetes. The preventive management of diabetes should receive priority attention, and the prevention of cardiovascular disease in the patient with diabetes should become an imperative.
Footnotes
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Address correspondence and reprint requests to Keith G. Dawson, MD, PHD, Professor (Emeritus), University of British Columbia, 380-575 West 8th Ave., Vancouver, BC Canada V5Z 1C6. E-mail: kdaw{at}interchange.ubc.ca.
Received for publication 16 November 2001 and accepted in revised form 17 April 2002.
H.G. has received speaker’s fees, honoraria, and consulting fees from Aventis, Merck, Novo Nordisk, GSK, Novartis, and Pfizer and has received grant support from Aventis, GSK, and Pfizer. K.G.D. has received funding for research from Servier Canada, Sanofi-Winthrop, GlaxoSmithKline, Knoll Pharmaceuticals, and Jansen-Ortho; has served on the advisory board to GlaxoSmithKline, Novo Nordisk, Eli Lilly, Abbott, and Roche; and has received honoraria from GlaxoSmithKline, Sanofi, Bristol Meyers Squib, Merck Frosst Canada, Novo Nordisk, Servier Canada, Novartis, Aventis, and Pfizer Canada.
K.H.K. is currently affiliated with Novartis Pharmaceuticals, East Hanover, New Jersey.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
- DIABETES CARE
