DIRECT MEDICAL COSTS OF COMPLICATIONS RESULTING FROM TYPE-2 DIABETES IN THE US

OBJECTIVE - To estimate direct medical costs of managing the complicat ions of type 2 diabetes. RESEARCH DESIGN AND METHODS - Costs were esti mated for 15 diabetic complications by applying unit costs to typical resource-use profiles. Resource use and unit costs were estimated from many sources, including acute care discharge databases, clinical guid elines, government reports, fee schedules, and peer-reviewed literatur e. For each complication, the event costs are those associated with re source use that is specific to the acute episode and any subsequent ca re occurring in the Ist year. State costs are the annual costs of cont inued management. All costs are expressed in 1996 U.S. dollars. RESULT S - As expected, the more severe or debilitating events, such as acute myocardial infarction ($27,630 event cost; $2,185 state cost), genera te a greater financial burden than do early-stage complications, such as microalbuminuria ($62 event cost; $14 state cost). Yet, complicatio ns that are initially relatively low in cost (e.g., microalbuminuria) can progress to more costly advanced stages (e.g., end-stage renal dis ease, $53,659 state cost); therefore, minor complications should also be considered in any economic analysis of diabetes. CONCLUSIONS - The recent literature has lacked cost estimates that may be readily transl ated into patient-level cost inputs for an economic model. Emerging th erapies that may reduce the incidence of some diabetic complications w ill need to be scrutinized economically in today's cost-conscious envi ronment. The cost. estimates from this study provide one piece of the economic analysis needed to evaluate these new interventional therapie s.