Diabetes costs: 1 in every 10 healthcare dollars

The economic cost of diagnosed diabetes totaled $245 billion in 2012, according to an analysis by the American Diabetes Association. The 41 percent increase from 2007 costs was fueled by a spike in diabetes prevalence.

The report, published online March 6 in Diabetes Care, builds on previous analyses released in 2002 and 2007. Like its predecessors, the 2012 study used a prevalence-based approach to estimate medical costs with modifications to refine methodology when appropriate. The analysis used numerous data resources, the Cost of Diabetes Model, Census Bureau figures to estimate diabetes prevalence and Centers for Disease Control and Prevention mortality data. Cost estimates were presented in 2012 dollars.

The researchers determined that 22.3 million people in the U.S. have diagnosed diabetes, or 7 percent of the total population. The cost of diabetes in the U.S. totaled $245 billion, with 72 percent of that amount in direct healthcare expenditures and the remainder in lost and reduced productivity.

More than one of every 10 healthcare dollars is directly attributed to diabetes, according to the report.

The largest slice of medical costs went to hospital inpatient care, accounting for 43 percent of the total. Researchers estimated that 25.7 percent of a projected 168 million hospital inpatient days in 2012 were by people with diagnosed diabetes, with more than half of those days directly due to diabetes. Of a projected $475 billion in nationwide hospital inpatient care expenditures, $76 billion was directly attributed to diabetes.

“The number of hospital inpatient days incurred by people with diabetes and those that are attributable to their diabetes have both increased from the 2007 level by about 6 and 9 percent, respectively, although the national utilization of hospital inpatient care has decreased by about 10 percent from 186 million days in 2007 to 168 million days in 2012 based on the analysis of NIS [Nationwide Inpatient Sample] data,” the authors wrote.

Diabetes also was listed as the primary reason for 40 percent of hospital outpatient visits and one third of physician office visits.

Healthcare expenditures for people are 2.3 times higher than expenditures for those without diabetes, a multiple that is unchanged from 2007. That translates into $7,888 in excess expenditures per diabetic patient per year, the researchers calculated.

They also attributed 246,000 deaths in 2012 to diabetes, and in 30 percent of these deaths, diabetes was listed as the primary cause.

They pointed out that their estimates reflect only diagnosed diabetes. Undiagnosed diabetes was associated with an additional $18 billion in costs in 2007, while prediabetes may add another $25 billion to costs.  

“On the surface it appears that the financial burden of diabetes falls primarily on insurers who pay a substantial portion of medical costs, employers who experience productivity loss, and the people with diabetes and their families who incur higher out-of-pocket medical costs and reduced earnings potential or employment opportunities,” they wrote. “Ultimately, though, the burden is passed along to all of society in the form of higher insurance premiums and taxes, reduced earnings, and reduced standard of living.”

Their estimates may be conservative because they fail to include the cost of over-the-counter medications, the cost of prevention programs and related administrative costs. They did not attempt to quantify intangible costs such as pain and suffering.