1 the costs of diabetes in europe don’t lose sight of the costs rhys williams prifysgol cymru...
DESCRIPTION
3 What are the costs? Direct costs (of health care) –to society –to the individual and the family Indirect costs (of ‘lost production’) –Sickness absence, premature retirement and premature death Intangible costs –Reduced quality of life - anxiety, pain, discomfort etc.TRANSCRIPT
1
The Costs of Diabetes in
EuropeDon’t Lose Sight
of the Costs
Rhys WilliamsPrifysgol Cymru Abertawe
(University of Wales Swansea, UK)
2
The Costs of Diabetes in
EuropeWhat are the costs?
What can be done about them?
3
What are the costs?• Direct costs (of health care)
– to society– to the individual and the family
• Indirect costs (of ‘lost production’)– Sickness absence, premature
retirement and premature death• Intangible costs
– Reduced quality of life - anxiety, pain, discomfort etc.
4
CODE-2 – the Cost of Type 2 Diabetes
BEL
FRA
GER
ITA
NED
SPA
SWE
UK
All countries
735
751
8091263 909
1004
773
756
7000
Direct cost (Billions of Euros - 1998)
1.1
4.0
12.4
5.8
0.4
2.0
0.7
2.6
29.0
6
Complications and Hospital Costs
0
1
2
3
4
5
6
Cost
impa
ct fa
ctor
None Micro only Macro only Both
2.1x
3.1x
5.5x
7
What can be done be done about them?
• People with existing diabetes (type 1 & type 2)– Reducing the risk of complications
• For people at risk of type 2 diabetes– Primary prevention ‘stopping diabetes
before it starts’• These will reduce direct, indirect and
intangible costs
8
Intensive therapy is costly to start but less costly in
the long run
0
1000
2000
3000
4000
5000
6000
1 2 3 4 5 6 7 8 9 10
IntensiveBasic
9
Trials have now shown that physical activity and weight
loss reduce risk
Source: The N Engl J Med, Volume 346, No 6, page 399
10
Prevention of Type 2 Diabetes Mellitus by Changes in Lifestyle Among 522 Overweight Subjects with IGT.The Finnish Diabetes Prevention Study.
-5
0
5
10
15
20
25
Weight Change (kg) Cumulative Incidence ofType 2 Diabetes After 4
Years (%)
Wei
ght
Cha
nge
(kg)
& C
umul
ativ
e
Wei
ght
Cha
nge
(kg)
& C
umul
ativ
e
Inci
denc
e o
f T
ype
2 D
iabe
tes
(%)
Inci
denc
e o
f T
ype
2 D
iabe
tes
(%)
-3.5 kg-3.5 kg -0.8 kg-0.8 kg
11%11%
23%23%
Tuomilehto et al. N. Engl. J. Med (2001). 344, 1343.
P < 0.001P < 0.001
P < 0.001P < 0.001interventionintervention
controlcontrol
11
The Costs of Diabetes in
EuropeCosts are high and getting higherComplications are the most important ‘cost driver’Costs can be reduced through primary and secondary prevention