Diabetes imposes a large economic burden on healthcare systems. The International ... spending of $145 USD, compared to the US with the highest per capita ... United States of America. $281 billion. Guyana. $23 million. Canada. $20 billion.
Estimated healthcare expenditures due to diabetes in the North America and Caribbean Region
Joao Diogo da Rocha Fernandes1, Katherine Ogurtsova1, Leonor Guariguata1 , Ute Linnenkamp1, Till Seuring1, Ping Zhang2, Lydia Makaroff1 International Diabetes Federation, Brussels, Belgium 1
2 Division
Aims and objectives:
of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
Table 1 – Total health expenditure on diabetes per country in the IDF North America and Caribbean region in 2014
Diabetes imposes a large economic burden on healthcare systems. The International Diabetes Federation (IDF) Diabetes Atlas tracks healthcare expenditures related to diabetes globally and regionally1-4. Here, the 2014 estimates for the IDF North American and Caribbean region are presented (NAC).
Total health expenditure on diabetes (2012 USD)
Country
Total health expenditure on diabetes (2012 USD)
Country
Methods:
United States of America
$281 billion
Guyana
Health care expenditures due to diabetes for the region were calculated as a sum of the expenditures from 17 countries and territories, which was estimated using an attributional fraction model, taking in consideration the differences between gender and age groups 5-7. Data needed for the model were obtained from: 2014 estimates of population by age and sex from the United Nations World Population Prospects (2012), 2014 diabetes prevalence estimates from the IDF Diabetes Atlas Update (2014), 2012 health expenditure estimates (2012) from the World Health Organization, and expenditure ratios between people with and without diabetes from US Kaiser health insurance claims data (2002). Expenditures were expressed in 2012 US dollars (USD) (Figure1).
Canada
$20 billion
Belize
$10million
Mexico
$8 billion
St Lucia
$8 million
Antigua and Barbuda
$7 million
Figure 1 – Study design and data flow IDF prevalence estimates by age-group and gender 2014 (Pas)
UN population estimates (Nas)
WHO total health expenditure per capita (Cas)
Kaiser Permanent Northwest Region diabetes cost –ratio (Ras)
Trinidad and Tobago
$168 million
$23 million
Jamaica
$85 million
St Kitts and Nevis
$5 million
Bahamas
$76 million
Grenada
$4 million
Barbados
$35 million
St Vincent and the Grenadines
$3 million
Haiti
$29 million
Dominica
$3 million
Suriname
$28 million Figure 3 - Mean health expenditure per person with diabetes in the IDF North America and Caribbean region in 2014
$12,000 Mortality data, WHO burden of disease project
$10,902
USD
$9,000
$7,984 $6,741
$6,000
Transformed data
Adjust to age, and sex
$3,000
20% constant health expenditure
$91
$0
80% mortality related health expenditure
$372
$404
$461
$494
$543
$718
$763
$795
$893
$928 $1,120 $1,141 $1,239
$2,181
$1,583
Total health expenditure per person
Discussion: Total Health expenditure per person with diabetes
The estimated total healthcare expenditure on diabetes in the region was $310 billion (2012 USD), representing more than 50% of the World’s health expenditure on diabetes (Figure 2). This fact is in large part explained due to the US’s health expenditure on diabetes, which was $281 billion USD (Table1). Within the North American and Caribbean region, diabetes was responsible for 1 dollar in 8 of the regional total health spending in 2014. Regarding the health expenditure per capita, the North American and Caribbean region spent on average $8,011 USD per person with diabetes, against a world average of $1,583 USD. There were great disparities in health spending between countries within the region. Haiti had the lowest per capita spending of $145 USD, compared to the US with the highest per capita spending at $10,902 USD (Figure 3).
USD (billion)
Results : 350
Figure 2 - Total health expenditures on diabetes in 2014 (USD)
When analyzed the distribution of the health expenditure on diabetes across sex and age groups a large diversity was observed (Figure 5). The age-group with the highest spending was the 5.2 million females aged 60-69 ($47 billion USD). The age-group with the lowest level of spending was the 0.7 million males aged 20-29 ($5.7 billion USD).
300 250 200
$310
150 100
billion
50
0
$302
Rest of the World
World
11%
Lower Middle-Income
10.4%
High-Income
12.8%
NAC
12.9%
Upper Middle-Income
15.7%
Low-Income
8.9% 4%
8%
12%
60-69 50-59 Male Female
40-49 30-39
The 6th Edition of the IDF Diabetes Atlas was supported by the following sponsors: Lilly Diabetes, Merck and Co, Inc., Novo Nordisk A/S supported through an unrestricted grant by the Novo Nordisk Changing Diabetes® initiative, Pfizer, Inc., and Sanofi Diabetes References: 1. IDF Diabetes Atlas, 3rd Ed. Brussels, Belgium: International Diabetes Federation; 2006. 2. IDF Diabetes Atlas, 4th Ed. Brussels, Belgium: International Diabetes Federation; 2009. 3. IDF Diabetes Atlas, 5th Ed. Brussels, Belgium: International Diabetes Federation; 2011. 4. IDF Diabetes Atlas, 6th Ed. Brussels, Belgium: International Diabetes Federation; 2013 5. The cost burden of diabetes mellitus: the evidence from Germany—the CoDiM Study, Köster I, von Ferber L, Ihle P, Schubert I, Hauner H. ; 2006. 6. American Diabetes Association. Economic Costs of Diabetes in the U.S. in 2012, American Diabetes Association; 2013 7. Medical Care and Payment for Diabetes in China: Enormous Threat and Great Opportunity Yang W, et al; 2012 8. Cost-Effectiveness of Interventions to Prevent and Control Diabetes Mellitus: A Systematic Review. Li R, Zhang P, Barker LE, Chowdhury FM, Zhang X ; 2010
16%
70-79
billion
North America and Caribbean region
Figure 4 - Percentage of money spent on diabetes from total expenditure on health in NAC in 2014
Figure 5 - Health expenditure on diabetes by sex and age group in the IDF North America and Caribbean region in 2014
Age
Total Health expenditure on diabetes (D)
The 2014 estimates on the total health expenditures on diabetes confirm the large economic impact caused by diabetes on health systems. This is observed across low-, middle- and high-income countries of the North America and Caribbean region (Figure 4). In upper middle-income countries, a larger share of resources (15.7%) was allocated to diabetes, over 3% more than the regional average (12.9%).
20-29 -$60
Conclusion:
-$40
-$20
$0
$20
$40
$60 Billions USD
The prevalence of diabetes and the overall expenditure associated with it have been on the rise for the past decade 1-4. In 2014, the estimated total healthcare expenditure on diabetes in the IDF North America and Caribbean region was USD $310 billion, representing more than 50% of the global health expenditure on diabetes of $612 billion USD. The North American and Caribbean region spent on average $8,011 USD per person with diabetes, substantially higher than the world average of $1,583 USD.
Presented at the American Diabetes Association 75th Scientific Sessions #2015-A-4004-Diabetes, Presentation number 1328-P
