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The Costs of Diabetes

Global Economic Burden of Diabetes in Adults: Projections From 2015 to 2030

  1. Christian Bommer1⇑,
  2. Vera Sagalova1,
  3. Esther Heesemann1,
  4. Jennifer Manne-Goehler2,3,
  5. Rifat Atun3,4,5,
  6. Till Bärnighausen3,6,7,
  7. Justine Davies8,9 and
  8. Sebastian Vollmer1,3
  1. 1Department of Economics and Centre for Modern Indian Studies, University of Goettingen, Goettingen, Germany
  2. 2Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
  3. 3Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA
  4. 4Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA
  5. 5Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA
  6. 6Heidelberg Institute of Public Health, University of Heidelberg, Heidelberg, Germany
  7. 7Africa Health Research Institute, Somkhele, South Africa
  8. 8Centre for Global Health, King’s College London, London, U.K.
  9. 9MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of Witwatersrand, Johannesburg, South Africa
  1. Corresponding author: Christian Bommer, christian.bommer{at}wiwi.uni-goettingen.de.
Diabetes Care 2018 May; 41(5): 963-970. https://doi.org/10.2337/dc17-1962
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    Figure 1

    Summary of the main steps in the costing approach; we summarize the main components of the costing approach by conceptually dividing it into two interacting parts.

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    Figure 2

    Global distribution of costs by country in 2030 (as determined by authors’ calculations). Total costs as percentage of GDP for baseline scenario (A), past trends scenario (B), and target scenario (C).

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    Figure 3

    Regional economic burden: absolute and relative costs. Display of total absolute (2015 prices) and relative costs for different World Bank regions for the years 2015 and 2030. Numbers in parentheses are direct costs only. CA, Central Asia; EAP, East Asia and Pacific; LAC, Latin America and the Caribbean; MENA, Middle East and North Africa; SSA, sub-Saharan Africa.

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  • Table 1

    Overview of key statistics and results of projection scenarios

    2015Projection for 2030
    Baseline scenarioPast trends scenarioTarget scenario
    Included countries180180180180
    Population (billion)7.258.398.398.39
    Global GDP (trillion $)a73.53115.30115.30115.30
    Prevalence, age-group 20–79 years (%)8.8 (8.4–9.5)10.0 (9.5–10.7)11.8 (11.2–12.7)9.8 (9.4–10.5)
    Deaths in 1,000s, age-group 20–65 years3,148 (3,013–3,327)4,181 (4,001–4,412)4,566 (4,364–4,822)2,787 (2,668–2,941)
    Total costs (trillion $)a1.32 (1.28–1.37)2.25 (2.18–2.34)2.48 (2.41–2.58)2.12 (2.06–2.20)
    Direct costs (trillion $)a0.86 (0.83–0.89)1.51 (1.47–1.57)1.70 (1.65–1.77)1.50 (1.46–1.56)
    Indirect costs (trillion $)a0.46 (0.45–0.48)0.73 (0.71–0.77)0.78 (0.75–0.82)0.61 (0.60–0.65)
     Mortality (%)b45.748.146.438.3
     Dropout (%)b48.345.847.154.5
     Absenteeism (%)b3.93.94.14.6
     Presenteeism (%)b2.12.32.42.7
    Share indirect costs (%)c35.032.731.329.0
    Total costs/global GDP (%)1.8 (1.7–1.9)1.9 (1.9–2.0)2.2 (2.1–2.2)1.8 (1.8–1.9)
    Mean (total costs/GDP) (%)1.4 (1.4–1.4)1.6 (1.6–1.7)1.9 (1.8–1.9)1.5 (1.5–1.5)
     High-income countries only1.2 (1.2–1.3)1.3 (1.3–1.4)1.4 (1.4–1.5)1.3 (1.3–1.3)
     Middle-income countries only1.7 (1.6–1.7)2.0 (1.9–2.1)2.3 (2.3–2.4)1.8 (1.8–1.9)
     Low-income countries only0.7 (0.6–0.8)0.8 (0.8–1.0)1.0 (0.9–1.1)0.7 (0.7–0.8)
    • Data are presented as n unless indicated otherwise. Numbers in parentheses are 95% CI.

    • ↵aAbsolute costs and GDP are expressed in terms of constant 2015 U.S. dollars.

    • ↵bThe fraction of the respective indirect cost component in total indirect costs. 95% CI not shown.

    • ↵cThe fraction of total costs allotted to indirect costs. 95% CI not shown.

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Global Economic Burden of Diabetes in Adults: Projections From 2015 to 2030
Christian Bommer, Vera Sagalova, Esther Heesemann, Jennifer Manne-Goehler, Rifat Atun, Till Bärnighausen, Justine Davies, Sebastian Vollmer
Diabetes Care May 2018, 41 (5) 963-970; DOI: 10.2337/dc17-1962

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Global Economic Burden of Diabetes in Adults: Projections From 2015 to 2030
Christian Bommer, Vera Sagalova, Esther Heesemann, Jennifer Manne-Goehler, Rifat Atun, Till Bärnighausen, Justine Davies, Sebastian Vollmer
Diabetes Care May 2018, 41 (5) 963-970; DOI: 10.2337/dc17-1962
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