The Health Care Costs of Diabetic Peripheral Neuropathy in the U.S.
- Adam Gordois, MSC1,
- Paul Scuffham, PHD1,
- Arran Shearer, MSC1,
- Alan Oglesby, MPH2 and
- Janet Ash Tobian, MD, PHD2
- 1York Health Economics Consortium, University of York, York, U.K.
- 2Global Health Outcomes, Eli Lilly and Company, Indianapolis, Indiana
Abstract
OBJECTIVE—Peripheral neuropathy is common among people with diabetes and can result in foot ulceration and amputation. The aim of this study was to quantify the annual medical costs of peripheral neuropathy and its complications among people with type 1 and type 2 diabetes in the U.S.
RESEARCH DESIGN AND METHODS—A cost-of-illness model was used to estimate the numbers of diabetic individuals in the U.S. who have diabetic peripheral neuropathy (DPN) and/or neuropathic foot ulcers (both those with no deep infection and those accompanied by cellulitis or osteomyelitis) at a given point in time, and/or a toe, foot, or leg amputation during a year. Prevalence and incidence rates were estimated from published studies and applied to the general U.S. population. All costs were estimated in 2001 U.S. dollars. In a sensitivity analysis, we varied the rates of complications to assess the robustness of the cost estimates.
RESULTS—The annual costs of DPN and its complications in the U.S. were $0.8 billion (type 1 diabetes), $10.1 billion (type 2 diabetes), and $10.9 billion (total). After allowing for uncertainty in the point estimates of complication rates, the range of costs were between $0.3 and $1.0 billion (type 1 diabetes), $4.3b and $12.7 billion (type 2 diabetes), and $4.6 and $13.7 billion (type 1 and type 2 diabetes).
CONCLUSIONS—The total annual cost of DPN and its complications in the U.S. was estimated to be between $4.6 and $13.7 billion. Up to 27% of the direct medical cost of diabetes may be attributed to DPN.
Footnotes
-
Address correspondence and reprint requests to Paul Scuffham, York Health Economics Consortium, Market Square (level 2), University of York, Vanbrugh Way, Heslington, York, YO10 5NH, U.K. E-mail: pas8{at}york.ac.uk.
Received for publication 12 October 2002 and accepted in revised form 14 March 2003.
York Health Economics Consortium has received consulting fees from Eli Lilly and Company to undertake impartial research into the health care costs of diabetic peripheral neuropathy.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
- DIABETES CARE
