Assessment of the Direct Medical Costs of Type 2 Diabetes Mellitus and its Complications in Turkey

Abstract

To estimate the direct annual medical costs of Type 2 diabetes and its complications in diagnosed patients in Turkey. Material and Method: A cost-of-illness model was developed. The prevalence of Type 2 diabetes was derived from the Turkish Diabetes Epidemiology Study, estimated as 13.7% in adults, with one-third of patients previously undiagnosed. Complication costs were extracted from the records of 7095 patients at a Turkish tertiary care hospital in 2009. For each modelled complication, acute phase costs were applied to globally derived incidence rates, and one-year follow-up costs were applied to globally derived prevalence rates. Costs and frequencies of ongoing antihyperglycaemic treatment and disease management were derived from treatment guidelines and Turkish hospital records. Parameter variation was performed. Results: The cost of Type 2 diabetes in diagnosed patients was estimated at between 11.4 to 12.9 billion Turkish Lira, 1% of Gross Domestic Product. Cardiovascular complications comprised the largest share of total medical costs (between 24.3% and 32.6%), followed by renal complicationsrelated costs (between 25% and 28.3%) and concomitant cardiovascular and antihypertensive medication costs (between 14.2% and 16%). Antihyperglycaemic medications and screening costs comprised between 10.9% to 12.3% and between 4.4% to 5% of total costs, respectively. Discussion: Type 2 diabetes is a disease burden and economic burden in Turkey; the complications cost is higher than the cost of disease control. For preventing complications, any activities effect positively limited resources and also quality of life.

Resource use associated with type 2 diabetes in Africa, the Middle East, South Asia, Eurasia and Turkey: results from the International Diabetes Management Practice Study (IDMPS)

“…A large proportion of this cost is related to hospitalization rates, which if reduced can sharply reduce the personal and socioeconomic burden due to diabetes 22. Similarly, in Turkey, management of diabetes-related complications accounted for more than half of the total cost associated with T2D 23. In this multinational survey, patients from Eurasia had a much higher prevalence of macrovascular and microvascular complications than other regions (47% and 87%, respectively).…”

Cost-effectiveness analysis of type 2 diabetes in outpatient therapy in Turkey

“…These facts increase the significance of our present study. Previously, Malhan et al (6) conducted the largest cost effectiveness analysis of diabetes treatment in Turkey and exposed the total cost of diabetic complications. The total costs of complications of type 2 diabetes were estimated at between $3.93 and $4.44 billion and accounted for 1% of the gross domestic product (GDP).…”

Implication of Findings from International Studies on Hypoglycemia for Management of Diabetes in Insulin-treated Patients in Turkey

“…Almost half of the Turkish patients with diabetes are aged between 40 and 64 years (2), and good glycemic control to reduce the risk of hypoglycemia is essential for the economic well-being of patients and their families. In 2010, it was estimated that the direct cost of managing major hypoglycemia in Turkey was 87 Turkish lira per acute episode (33). Patients have been demonstrated to increase blood glucose monitoring in response to hypoglycemic episodes (19), which may also increase costs associated with the management of hypoglycemia (26).…”

“…PREFER, a study comparing premixed insulin and basal-bolus regimens, demonstrated a lower incidence of severe hypoglycemia for premixed therapy, compared with the basal-bolus regimen, while the rates of non-severe hypoglycemia, weight gain, and nocturnal hypoglycemia were similar (42). In contrast, comparison of premixed insulins and basal insulin therapy demonstrated a higher overall risk of hypoglycemia with premixed insulin analogs (4,43).…”