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

Abstract

Abstract Background Since the last decade, non-communicable diseases, most commonly diabetes mellitus (DM2) have become the main threat to global health. Based on a prevalence of 9 million diabetic patients per year, DM2 constitutes a considerable medical and economic burden in Germany. The healthcare spending and its cost drivers are not yet sufficiently known. Aims of the study The primary objective of this study was to describe the resource use in health care and the cost of DM2 treatment in Germany, focusing on the most significant cost drivers and opportunities for cost-savings. The secondary objective was to analyse the impact of technical progress on diabetes care. Methods A systematic literature search was conducted in PubMed and Embase. Following the PRISMA guidance, the review identified the study design, epidemiological approach, analytical perspective, and data collection approach in each of the included studies. Results From 1.965 records, the final sample included 41 articles. The annual diabetes-specific direct costs of DM2 ranged from 542 € to 6.323 € per patient. The most used method was the incremental or excess cost approach (1.8-fold higher costs compared to individuals without DM2). Intangible costs – such as psychological well-being - were randomly considered in the existing cost-of-illness studies.Confirmed risk factors included physical inactivity, obesity, genetic predispositions, and tobacco use.The major cost drivers are demographic change with aging, increasing obesity, the availability of medications and therapies and the increased use of medical services by patients. Conclusion DM2, based on the results of this study, constitutes a considerable medical and economic burden in Germany and has a serious impact on the government health expenditures.