A total cost perspective of type 1 and 2 diabetes mellitus in two South African medical schemes servicing the public healthcare sector

Abstract

Background. Diabetes is increasingly becoming a public health concern in South Africa (SA). There are limited available data on the costs of diabetes. Objectives. To provide a total cost perspective of diabetes using medical scheme claims data from two SA medical schemes servicing the public healthcare sector in 2015 and 2016. Methods. We analysed data from 2 363 diabetes patients. Direct diabetes care costs included medication, consumables, hospitalisation and routine laboratory tests. Indirect costs were calculated by allocating economic costs related to disability-adjusted life years. Results. The mean (standard deviation) age was 65.8 (13.4) years and women comprised 51% of the group. Hospitalisation (64.7% in 2015 and 65.5% in 2016) and medication (31.0% in 2015 and 21.1% in 2016) contributed the most to total direct costs. Total direct diabetes care costs mounted to ZAR2 452 per patient in 2015 and ZAR2 486 in 2016. Indirect costs were ZAR17 223 per patient in 2015 and ZAR18 711 in 2016. When direct and indirect costs were combined, the costs accrued to ZAR27.9 billion (ZAR19 675 per patient) in 2015 and ZAR29.9 billion (ZAR21 197 per patient) in 2016, representing 0.688% and 0.689% of the SA gross domestic product over the 2 years, respectively. Conclusions. Diabetes and its associated costs hold significant implications for the healthcare sector and the country’s economy. Large numbers of diabetic individuals remain undiagnosed and the true costs of diabetes might even be higher.