Despite a stable prevalence of diabetes, there has been a notable 7% increase in the direct medical costs associated with diabetes from 2017 to 2022.
In a comprehensive analysis, the American Diabetes Association (ADA) unveiled the Economic Costs of Diabetes in the U.S. in 2022 (Economic Report).
Conducted every five years, the report reveals that the total annual cost of diabetes in 2022 stands at $412.9 billion, encompassing $306.6 billion in direct medical costs and $106.3 billion in indirect costs. Notably, individuals with diagnosed diabetes now represent one in every four healthcare dollars spent in the U.S.
Key findings from the Economic Report highlight a 35% increase in medical costs for people living with diabetes over the past decade. Notable cost drivers include the augmented use of prescription medications beyond glucose-lowering medications, increased hospital inpatient services, diminished work productivity, and rising unemployment.
Additional insights include a 7% inflation-adjusted increase in the direct medical cost of diabetes between 2017 and 2022. National healthcare costs related to diabetes have surged by $80 billion in the last decade, reaching $307 billion in 2022 from $227 billion in 2012. On average, individuals with diagnosed diabetes incur medical expenditures 2.6 times higher than expected without diabetes.
After adjusting for inflation, insulin costs witnessed a 24% increase from 2017 to 2022, with spending tripling in the past ten years, rising from $8 billion in 2012 to $22.3 billion in 2022. The total cost of insulin and other medications for managing blood glucose increased by 26% in inflation-adjusted terms from 2017 to 2022.
Despite a lower prevalence rate, women with diabetes, on average, spend more than men on annual healthcare expenditures. Black Americans with diabetes incur the highest direct healthcare expenditures, while individuals with diabetes aged 65 and above spend approximately double per capita on annual healthcare expenditures compared to any other age group above 18.
A significant $106.3 billion (26%) of the total estimated national cost of diabetes is attributed to lost productivity at work, chronic disability-related unemployment, and premature mortality. Presenteeism, accounting for reduced work productivity, contributes $35.8 billion to annual indirect costs, while absenteeism, reflecting missed workdays, accounts for $5.4 billion in annual indirect costs.
The Economic Report’s authors, a multidisciplinary team of leading U.S. experts in diabetes care and costs, including physicians, epidemiologists, endocrinologists, healthcare researchers, economists, data scientists, and academics, collaborated to provide these insights.
Inadequate foot care among individuals with diabetes contributes to the risk of lower limb amputations (LLA). To understand the implications of sub-optimal treatment on the healthcare system, it is essential to assess the costs associated with LLA. As each amputation event is likely subject to unique situational factors, cost estimates should address this heterogeneity with appropriate data and statistical methods. To assess whether published figures satisfy this criterion, we conducted a literature review of the costs of LLA in people with diabetes in the U.S.
According to a report by Value In Health, a systematic search was conducted using PubMed, the Tufts CEA registry, and the AHRQ website to identify LLA studies in the U.S. published after 2000. For studies satisfying the inclusion/exclusion criteria, we extracted and critically evaluated study characteristics (e.g., data sources, definitions, and methodology), underlying data characteristics (e.g., patients and event rates), and all cost estimates. All costs were inflated to 2016 U.S. dollars.
The search identified 610 references, of which 15 satisfied the inclusion/exclusion criteria. These studies reported 27 cost estimates for eight distinct categories of LLA (one study reported charges rather than costs and was excluded). The methodologies employed did not appear to control treatment heterogeneity adequately, and in some studies, documentation was poor. Ten studies reported costs irrespective of LLA type (i.e., did not distinguish between minor vs. major) with a range of $10,103 to $67,773. Mean costs were $46,802 for seven estimates classified as minor and $73,222 for ten estimates of major amputations. Excluding one extreme outlier, the mean costs decreased to $16,355 and $55,874, respectively, but standard deviations remained large.
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