Burden of disease and costs associated with type 2 diabetes in emerging and established markets: systematic review analyses

Abstract

Objectives: To estimate the clinical and economic burden of type 2 diabetes (T2D) in established (EST) and emerging markets (EMG). Methods: Three systematic literature reviews were conducted in MEDLINE and Embase to capture all relevant publications reporting 1) the epidemiology of T2D and complications in T2D and 2) the economic burden of T2D and associated complications. Results: In total, 294 studies were included in this analysis. Evidence indicates a high and increasing overall prevalence of T2D globally, ranging up to 23% in EMG markets and 14% in EST markets. Undiagnosed cases were higher in EMG versus EST markets (up to 67% vs 38%), potentially due to a lack of education and disease awareness in certain regions, that could lead to important clinical and economic consequences. Poor glycemic control was associated with the development of several complications (e.g. retinopathy, cardiovascular diseases and nephropathy) that increase the risk of morbidity and mortality. Direct costs were up to 9-fold higher in patients with vs without T2D-related complications. Conclusions: The burden of T2D, related complications and inherent costs are higher in emerging versus established market countries. This review explores potential strategies to reduce costs and enhance outcomes of T2D treatment in developing countries.

Delineating the Type 2 Diabetes Population in the Netherlands Using an All-Payer Claims Database: Specialist Care, Medication Utilization and Expenditures 2016–2018

“…Within the diabetes population, over 90% of patients suffer from type 2 diabetes [4,5]. Many patients with type 2 diabetes do not only use diabetes-related care but also use care across the healthcare system for comorbidities, such as chronic obstructive pulmonary disease (COPD) or heart failure [6][7][8][9][10][11][12]. Almost all type 2 diabetes patients utilize medical specialist and pharmaceutical care.…”

Association Between the Diabetes Drug Cost and Cardiovascular Events for Type 2 Diabetes in Korea: A National Health Insurance Service Database Analysis

“…The direct medical costs for diabetes treatment is determined early, which seems to be cost-ineffective in the short term; however, many health bene ts accrue late [8]. In the long run, diabetic patients without complications can save nine times of the direct medical costs compared with those with diabetes-related complications [24]. The scenario analysis using the Italian National Health Service revealed that integrated management, such as control of HbA1c, microalbuminuria, cholesterol, and blood pressure levels, can reduce the diabetes costs by 17% [25].…”

Cost-Effectiveness of Gliclazide-Based Intensive Glucose Control vs. Standard Glucose Control in Type 2 Diabetes Mellitus. An Economic Analysis of the ADVANCE Trial in Vietnam

“…Therefore, sulphonylureas are probably more relevant than newer drug classes to emerging countries such as Vietnam (6,36). Recent analyses based on systematic literature reviews have highlighted that the clinical and economic burdens of T2DM are greater in emerging markets than in established markets (37), further emphasizing the need for affordable and sustainable strategies to reduce these burdens. It is also important to point out that generic versions of gliclazide are available, which would impact the cost (and therefore cost-effectiveness) of gliclazide-based regimens.…”