Costs and Its Drivers for Diabetes Mellitus Type 2 Patients in France and Germany: A Systematic Review of Economic Studies

Abstract

Background Type 2 diabetes represents an increasingly critical challenge for health policy worldwide. It absorbs massive resources for both patients and national economies to sustain direct and associated costs of treatment and indirect costs related to loss of work and wages. Last years are fuelling of innovations grounded on the remote control and personalised programs which are significantly improving the management of diabetes and the reduction of its related complications. In this view, this work attempts to update cost analysis reviews on type 2 diabetes, focusing on France and Germany, in order to explore most significant cost drivers and rooms for cost savings by technology advancement. Although characterized by different approaches in delivering care, France and Germany represent the primary European markets for diabetes technologies. Methods A systematic review of the literature was carried out in MEDLINE, Embase and EconLit for interventional, observational, and modelling studies on expenditures for type 2 diabetes management in France or Germany published since 2012. Included articles were analysed for annual direct, associated, and indirect costs of type 2 diabetes patients. An appraisal of study quality was performed. Results are summarised narratively. Results From 1.260 records, the final sample was composed of 24 papers selected according to predefined inclusion/exclusion criteria. Both France and Germany revealed a predominant focus on direct cost. Comparability was limited due to different study populations and cost categories used. Nevertheless, France seems to reimburse higher direct costs than Germany. Indirect costs were only available for Germany. According to prior literature, reported cost drivers are hospitalisation and prescriptions as well as higher HbA1c and BMI, treatment with insulin and complications all indicating the severity of the disease. Diversity in available data and in included costs limit the results and may explain differences found. Conclusions Preventing complications and glycaemic control are widely recognized as the most effective ways to govern the expenditure for the treatment of diabetes. The implementation of self-based supports, such as hybrid closed-loop metabolic, already implemented for type 1 diabetes management, are the key pillars for further debates and policymaking, involving the perspectives of both caregivers and patients.

Polish Women Have Moderate Knowledge of Gestational Diabetes Mellitus and Breastfeeding Benefits

“…Currently, the percentage of pregnancies affected by gestational diabetes mellitus is approximately 3–8% and the number of cases is systematically increasing [ 14 , 15 ]. The factors favoring the rapid development of diabetes include socio-cultural changes, aging societies, urbanization and modern lifestyles, i.e., the increased consumption of processed foods and carbohydrates, a significant reduction of the proportion of vegetables and fruit in the diet, and, finally, decreased physical activity [ 79 , 80 , 81 , 82 , 83 , 84 ].…”

“…The treatment of diabetes and its complications is expensive for both patients (due to the cost of anti-diabetic medication) and national economies (through the indirect costs incurred through loss of work, productivity or earnings) [ 81 ]. As reported by Wierzba et al [ 103 ], in Poland spending on diabetes treatment is increasing steadily, and approximately 80% of diabetics in Poland state that they cannot afford optimal, modern diabetes therapy [ 104 ].…”

Стандарти Належної Аптечної Практики Як Базис Реалізації Концепції Фармацевтичної Допомоги Пацієнтам Із Цукровим Діабетом

“…Згідно з публікаціями іноземних авторів, основними напрямками надання ФД хворим на ЦД є профілактика захворювання; підвищення комплаєнтності хворих на ЦД; взаємодія з лікарем і пацієнтом; персоніфікація обслуговування [21]. Аптечні заклади є найкращим місцем для впровадження програм управління хворобою, які виявляються досить ефективними [22].…”

The Global Threat of Non-Communicable Diseases – Cost and Drivers for Diabetes Type 2 in Germany

“…Total* 1.758-3.993 [16,17,19,26,46] Neuropathy, foot complications Hypoglycemia, hypoglycemic episode 101-2.966 [31,50] Note: *costs divided by all diabetic patients netic predispositions, and tobacco consumption (increase in insulin insensitivity) [21,[25][26][27][28]. It is striking that people with a low social status have a significantly higher risk of developing DM2, which is explained in the context of the risk situation (including unbalanced diet, nicotine abuse, obesity, physical inactivity) [2].…”