Table 8.
The cost of diabetes in Latin American and the Caribbean in 2015
| Indirect cost | Source | Cost (US$) |
|---|---|---|
| Number of people with DM |
41 576 396. Estimated by the Diabetes Atlas |
|
| Permanent disability | Number of persons with diabetes with permanent disability: 1 043 128. Estimated by multiplying the economically active diabetes population in each country by the proportion of people with permanent disability by age and gender. These proportions were calculated by estimating the proportion of people receiving benefits due to diabetes by age and gender in Brazil, adjusted by diabetes duration and the prevalence of chronic disabling diabetes complication in the Chilean database (those with amputations, Chronic Kidney Disease (CKD), blindness, cerebrovascular disease and infarctions), approximate 33.5% of the total population with diabetes. | |
| Cost calculated by multiplying years lost to disability by annual country GNP per capita. Cost of permanent disability in one year. |
16 204 846 613 |
|
| Temporary disability | The estimated number of person with diabetes in the labor force was estimated by discounting the unemployed (according to each country unemployment rate published by the World Bank) among those in working ages (20–64 y of age): 31 872 702. Number of sick days related to diabetes 10.5 days per person per year as per results of the ViCen survey. | |
| Number of years lost due sick days: 858 154. Cost calculated by multiplying years of productivity lost by GNP per capita. |
13 391 123 563 |
|
| Mortality | Estimated number of all causes deaths: 1 386 513. Calculated by the Population Attributable Fraction using OR obtained from the BES study. | |
| Estimated number of deaths among those with diabetes: 318 102 (173 532–461 789). | ||
| Estimated number of years lost due to premature mortality: 2 074 633. Years lost before age 65 y with a 3% discount rate. Cost calculated by multiplying years lost to premature mortality in each country by annual GNP per capita. |
27 585 053 690 |
|
|
Indirect cost total |
57 181 023 866 |
|
| Direct cost | ||
| Insulin | Scenario 1: Proportion of people with diabetes using insulin: 10%. | |
| Insulin consumption per year: 10 000 units per person | ||
| Number of insulin users: 4 053 699. Cost of insulin in each country obtained from the PAHO database. |
66 995 221 314 |
|
| Scenario 2: Proportion of people with diabetes using insulin: 20%. | ||
| Insulin consumption per year: 10 000 units per person | ||
| Number of insulin users: 6 914 458. Cost of insulin in each country obtained from the PAHO database. |
11 611 301 234 |
|
| Oral medication | Scenario 1: Oral medication consumption per year: 1500 tablets of Metformin. Users 50% of the diabetes population | |
| Oral medication users: 19 748 788. Cost of metformin in each country obtained from the PAHO database. |
44 028 574 000 |
|
| Scenario 2: Oral medication consumption per year: 1500 tablets of Metformin. Users 80% of the diabetes population | ||
| Oral medication users: 33 572 940. Cost of metformin in each country obtained from the PAHO database. |
6 848 575 800 |
|
| Consultations | Scenario 1: Estimated that 50% of people were followed by health services.
Estimated number of consultations related to DM per year for people with diabetes: 105 312 278. Number of consultations per inhabitant from PAHO’s basic indicators. The ViCen survey indicated that people with diabetes had 3.5 more visits than those without diabetes. Visit for general causes were subtracted. The number of consultations due to diabetes was multiplied by the estimated number of people with diabetes in each country. The cost of consultations per country was obtained from the PAHO database. |
5 067 964 481 |
| Scenario 2: Estimated that 85% of people were followed by health services. Estimated number of consultations related to DM per year for people with diabetes: 162 755. Number of consultations per inhabitant from PAHO’s basic indicators. The ViCen survey indicated that people with diabetes had 3.5 more visits than those without diabetes. Visit for general causes were subtracted. The number of consultations due to diabetes was multiplied by the estimated number of people with diabetes in each country. The cost of consultations per country was obtained from the PAHO database. |
6 805 773 280 | |
| Hospitalizations |
Scenario 1–2: Total number of DM hospitalizations per year for people with diabetes: 18 293 614. The ViCen survey indicated that people with diabetes were hospitalized 7 times and hospital stay was 1.9 d longer than those without diabetes. Number of hospital discharges per inhabitant for the general population from the PAHO basic indicator database was used to estimate the excess hospital days due to diabetes in each country. Cost of one hospital day in each country obtained from the PAHO database. |
10 333 828 105 |
| Emergency visits |
Scenario 1–2: Total number of DM emergency visit per year for people with diabetes: 95 625 710; estimated number of diabetes related emergency visits 95 626. The ViCen survey indicated that people with diabetes had 1.4 more emergency visit than those without diabetes.
Number of emergency visits per inhabitant for the general population from the PAHO basic indicator database was used to estimate the excess emergency visits due to diabetes in each country. Only visits assumed to be related to diabetes were included in cost calculation. Cost of an emergency visit in each country obtained from the PAHO database. |
11 058 606 746 |
| Test and laboratory exams | Scenario 1: Includes the cost of one A1c, one lipid profile, one albuminuria test, one EKG, and one X Ray for 50% of the diabetes population of each country. Cost of items in each country obtained from the PAHO database. |
1 379 772 482 |
| Scenario 2: Includes the cost of three A1c, one lipid profile, one albuminuria test, one EKG, and one X Ray for 50% of the diabetes population of each country. Cost of items in each country obtained from the PAHO database. |
2 858 452 553 |
|
| Excess cost of complications | Scenario 1: The age–and–gender weighted probability of diabetes complications (cardiovascular disease 0.11, nephropathy 0.06, neuropathy 0.09, peripheral vascular disease 0.06 and retinopathy 0.12) was obtained from the Chilean QUALIDIAB database. The excess cost of each diabetes complication was applied to the cost of uncomplicated cases following results from the Mexican NIH database (excess cost of complications: neuropathy 1.08; peripheral vascular disease 11.06; cardiovascular disease 1.23; nephropathy 11.76; retinopathy 1.09) |
16 256 804 668 |
| Scenario 2: The age–and–gender weighted probability of diabetes complications (cardiovascular disease 0.11, nephropathy 0.06, neuropathy 0.09, peripheral vascular disease 0.06 and retinopathy 0.12) was obtained from the Chilean QUALIDIAB database. The excess cost of each diabetes complication was applied to the cost of uncomplicated cases following results from the Mexican NIH database (excess cost of complications: neuropathy 1.58; peripheral vascular disease 1.81; cardiovascular disease 1.86; nephropathy 2.96; retinopathy 1.86) |
26 587 999 416 |
|
| Direct cost total | Scenario 1 |
45 120 771 799 |
| Scenario 2 |
66 104 537 136 |
|
| Total Cost of DM | Scenario 1 |
102 301 795 665 |
| Scenario 2 | 123 285 561 002 |
DM – diabetes mellitus, y – year