The international dollar is a common currency unit that takes into account differences in the relative purchasing power of various currencies. Figures expressed in international dollars are calculated using purchasing power parities (PPP), which are rates of currency conversion constructed to account for differences in price level between countries.
Economic aspects of diabetes and diabetes care continue to attract attention as the world diabetes epidemic progresses and the healthcare sectors of countries remain under pressure to accomplish more and more within constrained resources. The annual direct healthcare costs of diabetes worldwide, for people in the 20-79 age bracket, are estimated to be at least 153 billion international dollars and may be as much as 286 billion.
If predictions of diabetes prevalence are fulfilled, total direct healthcare expenditure on diabetes worldwide will be between 213 billion and 396 billion international dollars in 2025. This would mean that the proportion of the world's healthcare budget being spent, in 2025, on diabetes care will be between 7% and 13% with high prevalence countries, such as Nauru, spending up to 40% of their budget.
The economic impact of diabetes is therefore considerable. The costs of diabetes affect health services, national productivity as well as individuals and families. Hospital in-patient costs for the treatment of complications are the largest single contributor to direct healthcare costs. Many of these complications and, therefore, their costs are preventable. Intensive therapy, directed at the control of blood glucose, blood pressure etc, has been shown to be cost-effective in that, although initial costs are increased, it decreases longer term costs as a result of delayed or prevented complications.
In many countries a substantial proportion of healthcare costs are borne by the individual and the family. Estimates of the indirect cost of diabetes ie the cost of lost production are as high as direct costs or even higher than those for direct costs.
Economic information is an important component in making decisions about diabetes and diabetes healthcare. Governments, diabetes associations, health professionals and people with diabetes themselves need to be aware of the current and future economic impact of the disease on the healthcare sector, the individual and family, and society as a whole. They also need to be aware of the potential for reducing this cost burden by increasing the effectiveness of surveillance and treatment for those who already have diabetes, by implementing primary prevention measures for those who are at high risk of developing type 2 diabetes and reducing the risk profile for type 2 diabetes in the population as a whole.
IDF's Task Force on Diabetes Health Economics has completed a review of currently available information on the cost-effectiveness of interventions relevant to diabetes prevention and care1International Diabetes Federation. Cost-effective approaches to diabetes care and prevention. IDF Task Force on Diabetes Health Economics. International Diabetes Federation, Brussels, 2003.. A large number of interventions - intensive blood glucose and blood pressure control, the use of lipid lowering agents, screening for and treatment of diabetic retinopathy and active care of the feet, for example - are known to be effective. Evidence is accumulating that many of these are also cost-effective, or even cost-saving. Many of the costs of diabetes and its complications are, therefore, potentially preventable.