Exp Clin Endocrinol Diabetes 2011; 119(6): 377-385
DOI: 10.1055/s-0030-1269847
Article

© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Direct Costs of Diabetes Mellitus in Germany – CoDiM 2000–2007

I. Köster1 , E. Huppertz2 , H. Hauner3 , I. Schubert1
  • 1PMV forschungsgruppe an der Klinik und Poliklinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Klinikum Köln, Germany
  • 2Niedererbach, Germany
  • 3Else Kröner-Fresenius-Zentrum für Ernährungsmedizin, Klinikum rechts der Isar der Technischen Universität München, Germany
Further Information

Publication History

received 27.09.2010 first decision 27.09.2010

accepted 17.11.2010

Publication Date:
24 January 2011 (online)

Abstract

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.

References

  • 1 Albrecht M, de Millas C, Hildebrandt S. et al .Die Bedeutung von Wettbewerb im Bereich der privaten Krankenversicherungen vor dem Hintergrund der erwarteten demografischen Entwicklung. Forschungsprojekt des Bundesministeriums für Wirtschaft und Technologie. Schlussbericht IGES Institut GmbH, Berlin; 2010: 91-99
  • 2 American Diabetes Association . Economic costs of diabetes in the US in 2002.  Diabetes Care. 2003;  26 917-932
  • 3 American Diabetes Association . Economic Costs of Diabetes in the US in 2007.  Diabetes Care. 2008;  31 596-615
  • 4 Brandle M, Zhou H, Smith BRK. et al . The direct medical cost of type 2 diabetes.  Diabetes Care. 2003;  26 2300-2304
  • 5 BMG – Bundesministerium für Gesundheit Berlin . Gesetzliche Krankenversicherung – Kennzahlen und Faustformeln – Status: 4 March 2009.  Available from http://www.bmg.bund.de Assessed 28 January 2010; 
  • 6 DESTATIS – Statistisches Bundesamt Wiesbaden . Gesundheit-Ausgaben, Krankheitskosten und Personal-Methodik.  Available from http://www.gbe-bund.de/gbe10/ergebnisse.prc.achkz=D&p_uid=gasts&p_ aid=44013136&p_prot=1 Assessed 12 August 2010a; 
  • 7 DESTATIS – Statistisches Bundesamt Wiesbaden . Gesundheit-Krankheitskosten 2002, 2004 und 2006.  Statistisches Bundesamt Wiesbaden 2008; 
  • 8 DESTATIS – Statistisches Bundesamt Wiesbaden . Gesundheitsberichterstattung des Bundes.  Available from http://www.gbe-bund.de Rahmenbedingungen>Gesetzliche Krankenversicherung>GKV, Mitglieder/Versicherte Assessed 6 August 2010b; 
  • 9 Engelgau MM, Geiss LS, Saaddine JB. et al . The evolving diabetes burden in the United States.  Ann Intern Med. 2004;  140 945-950
  • 10 Ettaro L, Songer TJ, Zhang P. et al . Cost-of-illness studies in diabetes mellitus.  Pharmacoecon. 2004;  22 149-164
  • 11 Giani G, Janka HU, Hauner H. et al .Epidemiologie und Verlauf des Diabetes mellitus in Deutschland. In: Scherbaum WA, Kiess W (eds) Evidenzbasierte Leitlinie Deutsche Diabetes Gesellschaft – Update May Available from http://www.deutsche-diabetes-gesellschaft.de/redaktion/mitteilungen/leitlinien/EBL_Epidemiologie_Update_2004.pdf Assessed 13 August 2010 2004
  • 12 Hauner H, Köster I, von Ferber L. Prevalence of diabetes mellitus in Germany 1998–2001. Sekundärdaten einer Versichertenstichprobe der AOK Hessen/KV Hessen.  DMW. 2003;  128 2632-2637
  • 13 Hauner H, Köster I, Schubert I. Trends in der Prävalenz und ambulanten Versorgung von Menschen mit Diabetes mellitus. Eine Analyse der Versichertenstichprobe AOK Hessen/KV Hessen im Zeitraum von 1998 bis 2004.  Dtsch Arztebl. 2007;  104 (41) A805-A2799
  • 14 Henriksson F, Agardh CD, Berne C. et al . Health economics analysis of diabetes is necessary. It facilitates decision-making and international comparison. Health economics analysis of diabetes is necessary.  Lakartidningen. 1999;  96 3915-3916 3919
  • 15 Ihle P, Köster I, Herholz H. et al . Versichertenstichprobe AOK Hessen/KV Hessen – Konzeption und Umsetzung einer personenbezogenen Datenbasis aus der Gesetzliche Krankenversicherung.  Gesundheitswesen. 2005;  67 638-645
  • 16 International Diabetes Foundation (IDF) Diabetes Atlas 2010 . Available from http://www.diabetesatlas.org/downloads Assessed 6 August 2010; 
  • 17 Jönsson B. Revealing the cost of Type II diabetes in Europe.  Diabetologia. 2002;  45 S5-S12
  • 18 Köster I, von Ferber L, Ihle P. et al . The cost burden of diabetes mellitus: the evidence from Germany – the CoDiM Study.  Diabetologia. 2006;  49 1498-1504
  • 19 Liebl A, Spannheimer A, Reitberger U. et al . Kosten für Spätkomplikationen bei Diabetes mellitus Typ 2 in Deutschland. Ergebnisse der CODE-2 Studie.  Med Klin. 2002;  97 713-719
  • 20 Noethen M. Men and women in the public health system: A comparison of costs. STATmagazin; Federal Statistical Office, Wiesbaden, Germany; 2009. 3 February 2009. Available from http://www.destatis.de/jetspeed/portal/cms/Sites/destatis/Internet/EN/Content/Publikationen/STATmagazin/Health/2009__02/PDF2009__02.psml Assessed 6 August 2010
  • 21 Pohar SL, Johnson JA. Health care utilization and costs in Saskatchewan's registered Indian population with diabetes.  BMC Health Serv Res. 2007;  7 126
  • 22 Selby JV, Ray GT, Zhang D. et al . Excess costs of medical care for patients with diabetes in a managed care population.  Diabetes Care. 1997;  20 1396-1402
  • 23 Stock SAK, Redaelli M, Wendland G. et al . Diabetes – prevalence and cost of illness in Germany: a study evaluating data from the statutory health insurance in Germany.  Diabet Med. 2006;  23 299-305
  • 24 von Ferber L, Köster I, Hauner H. Costs of the treatment of hyperglycaemia in patients with diabetes mellitus. The impact of age, type of therapy and complications: Results of the German CoDiM study.  Med Klin. 2006;  101 384-393
  • 25 von Ferber L, Köster I, Hauner H. Medical Costs of Diabetic Complications – Total Costs and Excess Costs by Age and Type of Treatment: Results of the German CoDiM Study.  Exp Clin Endocrinol Diabetes. 2007;  115 97-104

Correspondence

I. Köster

PMV forschungsgruppe an

der Klinik und Poliklinik für

Psychiatrie und Psychotherapie

des Kindes- und Jugendalters,

Klinikum Köln

Herderstr. 52– 54

50931 Köln

Germany

Phone: +49/221/478 6545

Fax: +49/221/478 6766

Email: ingrid.koester@uk-koeln.de