Lifetime cost for type 2 diabetes mellitus in Singapore

Highlights This study looked at the lifetime costs of type 2 diabetes mellitus (T2DM) in Singapore. It was found that delaying the onset of T2DM may lead to lower lifetime medical spending, especially when the target population is younger. Background The mean annual direct medical cost of type 2 diabetes mellitus (T2DM) in Singapore has been found to be SGD 2034 using the prevalence‐based approach, but the lifetime direct medical cost of T2DM in Singapore remains largely unknown. The aim of the present study was to determine the lifetime direct medical cost attributable to T2DM and provide estimates of potential savings if T2DM can be prevented or delayed. Methods The incidence‐based approach was used for the cost‐of‐illness analysis. Yearly medical expenses were obtained from a regional health system database in Singapore to estimate the lifetime medical cost of T2DM patients. Then, the lifetime medical cost of non‐T2DM subjects was predicted using a regression model. From the database, gender‐ and age‐specific annual survival rates of T2DM and non‐T2DM subjects were obtained and survival‐adjusted yearly expenses over the estimated remaining life span were added to obtain lifetime medical costs. The difference between T2DM and non‐T2DM subjects was attributed to excess direct medical costs of T2DM. Results The excess lifetime medical expenses for T2DM patients were SGD 132 506, 108 589, 83 326 and 70 110 when the age of T2DM diagnosis was 40, 50, 60, and 65 years, respectively. Conclusions Even though T2DM patients have a lower life expectancy, T2DM is associated with substantially higher lifetime medical costs. Delaying the onset of T2DM, especially in the young, may lead to lower lifetime medical expenses. If prevention costs can be kept sufficiently low, effective T2DM prevention efforts would likely lead to a reduction in long‐term medical costs. 摘要 背景 使用基于流行病学的方法测算后发现新加坡2型糖尿病(T2DM)患者的每年平均直接医疗费用为2034新加坡元, 但是目前新加坡T2DM患者的终生直接医疗费用仍然未知。当前这项研究旨在调查T2DM导致的终生直接医疗费用以及如果能够预防或者推迟T2DM有可能会节约的费用。 方法 疾病费用分析使用了基于发病率的测算方法。用来评估T2DM患者终生医疗费用的每年的医疗费用来自于新加坡的一个区域卫生系统数据库。然后, 使用一个回归模型来预测非T2DM受试者的终生医疗费用。从这个数据库中获得了各个性别以及各个年龄组的T2DM与非T2DM受试者的年生存率, 并且为了获得终身医疗费用还要加上预估的剩余寿命中校正生存率后的年费用。T2DM与非T2DM受试者之间存在差异的原因是T2DM的直接医疗费用过高。 结果 当诊断T2DM的年龄为40、50、60或者65岁时,T2DM患者的超额终生医疗费用分别为132506、108589、83326或者70110 新加坡元。 结论 尽管T2DM患者的预期寿命较短, 但是T2DM与明显更高的终生医疗费用相关。延缓T2DM的发病, 特别是预防年轻人发病, 可能会降低终生医疗费用。如果预防费用能够保持在足够低的水平上, 那么有效的T2DM预防工作可能将会降低长期医疗费用。