Large Canadian study finds healthcare cost of people living with diabetes more than double that of people without the disease

Each person living with diabetes requires care that costs the Canadian healthcare system an average of $16,000 over eight years, compared to $6,000 in average healthcare costs for people who don’t live with diabetes, a new study has found.

The study is the most comprehensive Canadian analysis of healthcare costs related to diabetes to date, with a sample size of almost three million people.

Researchers at the University of Toronto’s Dalla Lana School of Public Health using data from the Institute for Clinical Evaluative Sciences (ICES) found that the average per-person healthcare spending for diabetes cases was more than twice that of non-diabetes controls and results in billions of dollars of healthcare related costs annually. Over the eight-year study, females living with diabetes cost the system $9,731 more than a non-diabetic female and males cost $10,315 more. Roughly $4,000 of these costs related to diabetes were incurred in the first year after diagnosis.

“Diabetes is one of the greatest public health and health system challenges of the 21st century because it’s among the most costly health conditions to manage,” said Laura Rosella, lead author, assistant professor at the Dalla Lana School of Public Health, adjunct scientist at ICES and scientist at Public Health Ontario. Dr. Rosella noted Canadian cost estimates directly attributable to diabetes were limited before this study.

The study, "Impact of diabetes on healthcare costs in a population-based cohort: a cost analysis" published in Diabetic Medicine, was funded by the Canadian Institutes of Health Research. It captured healthcare costs of almost three million people from 2004-2012 using patient-specific health administrative data, including hospitalizations, emergency visits, surgery, dialysis, clinic visits, prescription medications, laboratory, rehabilitation and home care and medical devices.

Researchers estimated annual attributable per-person costs — dollars spent directly as a result of diabetes-related care — as the difference in healthcare costs between diabetes cases and matched non-diabetes controls.

“We found that the older you are, the substantially higher the cost, and, even after adjusting for other complicated medical conditions and socioeconomic status, attributable diabetes costs are mostly due to hospitalizations, physician visits, prescription medications and medical devices,” said Rosella.

“For the 3.4 million Canadians living with diabetes, it decreases quality and length of life, and is a leading cause of kidney failure, lower limb amputation and blindness among adults,” says Dr. Jan Hux, chief science officer at the Canadian Diabetes Association. “Looking beyond the impact on individuals, this study documents the heavy and potentially unsustainable burden the condition poses to the healthcare system.”

Rosella, among many other researchers, predicts that diabetes prevalence will increase as a result of a population aging, rising obesity, sedentary lifestyles and decreased mortality rates among people with diabetes.

“It is critical to comprehensively estimate healthcare costs specifically due to diabetes in order to appropriately allocate health resources and more importantly to determine the economic benefit of diabetes prevention strategies, that is, the healthcare costs that could be averted if diabetes prevention efforts were to be scaled up,” said Rosella.

"Impact of diabetes on healthcare costs in a population-based cohort: a cost analysis" was published electronically ahead of print in the journal Diabetic Medicine.

Author block: Rosella LC, Lebenbaum M, Fitzpatrick T, O'Reilly D, Wang J, Booth GL, Stukel TA, Wodchis WP. 

About the Dalla Lana School of Public Health

The Dalla Lana School of Public Health is a Faculty of the University of Toronto that originated as one of the Schools of Hygiene begun by the Rockefeller Foundation in 1927. The School went through a dramatic renaissance after the 2003 SARS crisis and it is now the largest public health school in Canada, with over 800 faculty, 850 students, and research and training partnerships with institutions throughout Toronto and the world. With $27-million in research funding per year, the School supports discovery in global health, tobacco impacts on health, occupational disease and disability, air pollution, inner city and Indigenous health, among many other areas. For more information, visit the website.

About the Canadian Diabetes Association

The Canadian Diabetes Association (CDA) is the registered national charity that helps the more than 10 million Canadians with diabetes or prediabetes live healthy lives, and educates those at risk. In communities across Canada, the CDA: offers a wide array of support services to members of the public; offers resources to health-care professionals on best practices to care for people with diabetes; advocates to governments, schools, workplaces and others on behalf of people with diabetes; and funds research on better treatments and to find a cure. For more information, visit diabetes.ca or call 1-800-BANTING (226-8464).

About ICES

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. For the latest ICES news, follow us on Twitter: @ICESOntario

FOR MORE INFORMATION PLEASE CONTACT:

• Nicole Bodnar
• Director of Communications
• Dalla Lana School of Public Health, University of Toronto
• [email protected] / 416-946-7521

• Kathleen Sandusky
• Media Advisor, ICES
• [email protected] / (o) 416-480-4780 or (c) 416-434-7763