An economic model of the long-term health care burden of Type II diabetes

Aims/hypothesis: To develop a long-term economic model of health care for Type II diabetes initially for the United Kingdom; characterize experiences of diabetes-related morbidities and the use of health care resources among a typical Type II diabetes cohort; to estimate lifetime differences in expected health outcomes and costs attributable to Type II diabetes; and to facilitate evaluation of policies or interventions in treating Type II diabetes from the funder's perspective. Methods: A compact spreadsheet structure of interconnected Markov chain modules was developed to facilitate rapid estimation of costs and outcomes for whole populations. Recent clinical findings from the United Kingdom Prospective Diabetes Study and other sources were incorporated and a detailed costing module developed from United Kingdom observational data. Results: The model allows the assessment of costs and long-term complications experienced by people suffering from Type II diabetes, including direct health care costs associated with the main diabetic complications and second-order effects on other health services required by such patients. Initial results suggest that the lifetime cost of health care for patients from the diagnosis of diabetes is more than double that for an equivalent non-diabetic population. Conclusion/interpretation: The model is intended for use by health care policy makers and payers to assess the long-term budgetary impact of trends in a variety of demographic and epidemiological factors on future services, and is also useful to physicians when considering the impact of new treatment strategies or programmes to modify risk factors for diabetic complications. [Diabetologia (2001) 44: 2140–2155