Direct costs of diabetes mellitus in Germany - CoDiM 2000-2007

Introduction: The prevalence of treated diabetes in Germany and direct health care costs of individuals with diabetes were analysed for the 8-year period from 2000 to 2007, based on administrative data. Special interest was given to the incremental costs attributed to diabetes.

Material and methods: An 18.75% sample of all members of a large local German statutory health insurance provider, "AOK - Die Gesundheitskasse" in the federal state of Hesse was analysed with regard to cases of treated diabetes. To assess the incremental diabetes-related direct costs, the cost data of individuals with diabetes was compared to that of an age- and sex-matched group of persons without diabetes. Prevalence and costs were standardized according to the gender and age distribution of the German population.

Results: Between 2000 and 2007, the administrative prevalence of treated diabetes rose continuously in Germany, from 6.5 to 8.9% (+36.8%). The number of patients treated with 'insulin' or 'insulin & oral antidiabetic agents' increased by +54.7 and +61.7%, respectively. Direct costs per patient with diabetes, calculated using the unit costs reimbursed by statutory health and nursing care insurances, rose from € 5 197 to € 5 726 (+10.2%). Incremental per-capita costs were € 2 400 in 2000 and € 2 605 in 2007 (+8.5%). However, the total direct cost burden of diabetes in Germany grew from € 27.8 billion to € 42.0 billion (+51.1%). The incremental diabetes-related cost burden increased from € 12.9 billion to € 19.1 billion (+48.6%).

Conclusions: There was a continuous increase in the prevalence of diabetes in Germany during the 8-year period. Although there was only a modest increase in annual diabetes-related per-capita costs, total healthcare expenditure rose substantially due to the growing number of patients being treated for diabetes.