Type 2 diabetes consumes a large portion of China's health expenditures and will continue to place a heavy burden on the country's health budget in the future, research has found. The research is based on a study published in the American Journal of Managed Care.
The economic burden of type 2 diabetes makes it an important clinical and public health challenge in China, requiring policy makers to determine both the current and future economic burdens of the disease to formulate effective plans for resource allocation, the study suggested.
Diabetes Prevalence in China and Worldwide
Nearly 200 million people worldwide have type 2 diabetes, and this number is predicted to increase to 333 million by 2025. In China, more than 23 million people currently have diabetes, and that number is expected to almost double in 20 years. Between 1996 and 2006, diabetes prevalence increased rapidly in Chinese cities, from 4.6 percent to 7.7 percent, particularly in the largest cities.
Updated diabetes statistics are available from "Diabetes – A Major Public Health Problem in China."
Estimated Medical Cost of Diabetes
The study found that estimated national direct medical costs for diabetes and its complications was about $26 billion a year, or 18.2 percent of China's total health expenditures in 2007. These costs are projected to increase to more than $47 billion in 2030. Annual per patient direct medical costs of healthcare associated with diabetes patients with complications were about $1800, compared to $480 for those without complications.
Cost-saving Measures to Prevent Diabetes
Type 2 diabetes and its complications are preventable, and the costs of preventing and treating the condition can be reduced, according to the study. Preventive interventions, especially lifestyle interventions, and screening and treatment strategies may effectively decrease incidence and complications of diabetes and therefore save costs.
A previous study called the China Da Qing Diabetes Prevention Study reported a 51 percent reduction in new cases of diabetes as a result of lifestyle intervention among Chinese patients.
Interventions such as intensive blood sugar and blood pressure control, use of cholesterol-lowering drugs and screening for and treating diabetic retinopathy are known to be cost-effective and many of these interventions are also cost-saving.
Projected Savings from Preventive Interventions
The study projected that diabetes screening strategies for the general population may save $1.8 billion in 2030 by preventing the onset of diabetes, while more specific screening and treatment strategies—such as blood pressure control, annual screening for microalbuminuria, annual eye examination and foot care in high-risk patients—may save even more.
Estimated savings for screening and treatment strategies:
Blood pressure control - $3.5 billion
Glycemic control - $2.2 billion
Microalbuminuria screening - $1.5 billion
ACE inhibitor use - $1.1 billion
Aspirin use - $309 million
Eye exams - $55 million
Foot care - $64 million
Because excessive costs are largely due to treatment of complications, "the importance of preventing [type 2 diabetes] complications through the use of more effective treatment regiments is obvious," the study concluded.
Reference:
- Wang W, McGreevey WP, Fu C, et al. Type 2 diabetes mellitus in China: A preventable economic burden. Am J Manag Care 2009; 15(9): 593-601.
Juan Ramos - Juan Ramos is a health communication specialist based in Boston, Massachusetts, USA. He has worked in the non-profit sector for more than ...
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