Assessment of excess medical costs for persons with type 2 diabetes according to age groups: an analysis of German health insurance claims data. Issue 10 (23rd December 2019) - Kähm, K.
Abstract: Aim: This cross‐sectional study used a large nationwide claims data set to assess the excess medical costs of people with type 2 diabetes according to age group in 2015. Methods: Data from 291 709 people with diabetes and 291 709 age‐ and sex‐matched controls were analysed. Total costs (expressed as 2015 euros) of outpatient and inpatient services, medication, rehabilitation, and the provision of aids and appliances were examined. Overall and age‐stratified excess costs of people with diabetes were estimated using gamma regression with a log‐link. Results: Overall, the estimated total direct costs of a person with type 2 diabetes are approximately double those of a person without diabetes: €4727 vs. €2196, respectively. Absolute excess costs were approximately the same in all age groups (around €2500), however, relative excess costs of persons with diabetes were much higher in younger (~ 334% for < 50 years) than in older age groups (~ 156% for ≥ 80 years). Regional costs, both absolute and excess, partly differed from the national level. Conclusions: This study complements and updates previous studies on the excess medical costs of people with diabetes in Germany. The results indicate the importance of preventing the development of type 2 diabetes, especially in younger age groups. Longitudinal and regional studies examining changes in prevalence and the development of excess costs in groups with different types of diabetes, and according to age, would be of interest to validate our findings and better understand the avoidable burden of having diabetes. What's new?: Overall and complication‐related excess medical costs of people with type 2 diabetes have been examined previously. However, relative excess medical costs according to age group have not been determined. We found that relative excess costs of people with diabetes were much higher in younger (~ 334% for < 50 years) than older age groups (~ 156% for ≥ 80 years), but absolute cost differences were similarly high across all age groups. Thus, prevention and efforts to reverse diabetes in affected persons, especially those in younger age groups who have a longer prospect of generating healthcare costs could be valuable.