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Cost of diabetes in Croatia - where are we today and can we prevent health economic impact of it`s complications ?

Introduction Over the last 30 years, medical expenditure has increased at a considerably faster rate than other sectors of the economy. The world prevalence of diabetes mellitus is growing and the 90% of patients are those with type 2 (T2DM). Average time for establishing diagnose of T2DM is 8 years and almost a half of the subjects with T2DM in Croatia are still not diagnosed. The results of the UKPDS have demonstrated that yearly costs of T2DM increase by more than 50% when cardiovascular complications occur, and by 360% with a major cardiovascular event. Abnormal renal function increased treatment costs by 65%, and end-stage renal disease by 771%. The purpose of the study is to evaluate cost of T2DM in Croatia by assessing costs related to drug consumption, costs of diabetes complications and other indirect costs. The aim is to demonstrate that optimization of diabetes treatment holds a great potential to save lives, reduce years lived with lowered quality of life, and reduce total costs. Materials/Methods A prevalence based design was used with optimizing national data, while maintaining maximum comparability with European countries. Effort was made to ensure consistency in terms of cost specification, data collection tools and methods, sampling design and the analysis. Assumptions and variables relate to present epidemiology data, current prices defined by authorities, and were checked through probabilistic modelling. Results/Conclusion Total costs of T2DM treatment depends great deal upon the choice of drugs as well as upon complications development. The most expensive item in diabetes care is the emergence of complications. The results demonstrate that choosing an optimal therapy (not only decreasing effectivelly HbA1c values, but being able to simultaneously influence several risk factors and achiving favorable composite endpoint) significantly impacts total costs in a shorter time and particularly in a long term run Economic data on the costs of diabetes are essentail to optimise resource allocation.

Cost of diabetes; Croatia; health economic impact; complications

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