The Global Threat of Non-Communicable Diseases – Cost and Drivers for Diabetes Type 2 in Germany

Abstract

Background Since the last decade, non-communicable diseases, most commonly diabetes mellitus (DM2) have become the main threat to global health. Based on a prevalence of 9 million diabetic patients per year, DM2 constitutes a considerable medical and economic burden in Germany. The healthcare spending and its cost drivers are not yet sufficiently known.

Aims of the study The primary objective of this study was to describe the resource use in health care and the cost of DM2 treatment in Germany, focusing on the most significant cost drivers and opportunities for cost-savings. The secondary objective was to analyse the impact of technical progress on diabetes care.

Methods A systematic literature search was conducted in PubMed and Embase. Following the PRISMA guidance, the review identified the study design, epidemiological approach, analytical perspective, and data collection approach in each of the included studies.

Results From 1.965 records, the final sample included 41 articles. The annual diabetes-specific direct costs of DM2 ranged from 542 € to 6.323 € per patient. The most used method was the incremental or excess cost approach (1.8-fold higher costs compared to individuals without DM2). Intangible costs – such as psychological well-being - were randomly considered in the existing cost-of-illness studies.

Confirmed risk factors included physical inactivity, obesity, genetic predispositions, and tobacco use.

The major cost drivers are demographic change with aging, increasing obesity, the availability of medications and therapies and the increased use of medical services by patients.

Conclusion DM2, based on the results of this study, constitutes a considerable medical and economic burden in Germany and has a serious impact on the government health expenditures.

Zusammenfassung

Hintergrund In den letzten Jahren haben sich nicht übertragbare Krankheiten, vor allem Diabetes mellitus (DM2), zur größten Bedrohung für die globale Gesundheit entwickelt. Bei einer Prävalenz von 9 Millionen Diabetikern pro Jahr stellt DM2 in Deutschland eine erhebliche medizinische und wirtschaftliche Belastung dar. Die Gesundheitsausgaben und ihre Kostenfaktoren sind noch nicht ausreichend bekannt.

Ziele der Studie Das primäre Ziel dieser Studie war es, den Ressourcenverbrauch im Gesundheitswesen und die Kosten der DM2-Behandlung in Deutschland zu beschreiben, wobei der Schwerpunkt auf den wichtigsten Kostentreibern und Möglichkeiten zur Kosteneinsparung lag. Das sekundäre Ziel war es, die Auswirkungen des technischen Fortschritts auf die Diabetesversorgung zu analysieren.

Methoden Es wurde eine systematische Literaturrecherche in PubMed und Embase durchgeführt. In Anlehnung an den PRISMA-Leitfaden wurden das Studiendesign, der epidemiologische Ansatz, die Analyseperspektive und die Art der Datenerhebung in jeder der eingeschlossenen Studien identifiziert.

Ergebnisse Von 1.965 Datensätzen umfasste die endgültige Stichprobe 41 Artikel. Die jährlichen diabetes-spezifischen direkten Kosten von DM2 lagen zwischen 542 € und 6.323 € pro Patient. Die am häufigsten angewandte Methode war der Ansatz der inkrementellen oder überschüssigen Kosten (1,8-fach höhere Kosten im Vergleich zu Personen ohne DM2). Immaterielle Kosten – wie das psychische Wohlbefinden – wurden in den vorhandenen Krankheitskostenstudien nur stichprobenartig berücksichtigt.

Zu den bestätigten Risikofaktoren gehörten Bewegungsmangel, Fettleibigkeit, genetische Veranlagung und Tabakkonsum. Die wichtigsten Kostentreiber waren der demografische Wandel mit Alterung der Bevölkerung, die zunehmende Fettleibigkeit, die Verfügbarkeit von Medikamenten und Therapien sowie die verstärkte Inanspruchnahme medizinischer Leistungen durch die Patienten.

Schlussfolgerung DM2 stellt nach den Ergebnissen dieser Studie eine beträchtliche medizinische und wirtschaftliche Belastung in Deutschland dar und hat einen erheblichen Einfluss auf die staatlichen Gesundheitsausgaben.

Keywords

Health Economics - Cost - Diabetes - Germany - Economic Impact

Schlüsselwörter

Gesundheitsökonomie - Kosten - Diabetes - Deutschland - Wirtschaftliche Auswirkungen

^* Scherdjow A and Kiefer S share first authorship.

Publication History

Article published online:
01 August 2022

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