The impact of diabetes-related complications on healthcare costs: results from the United Kingdom Prospective Diabetes Study (UKPDS Study No. 65)

Aims To develop a model for estimating the immediate and long-term healthcare costs associated with seven diabetes-related complications in patients with Type 2 diabetes participating in the UK Prospective Diabetes Study (UKPDS). Methods The costs associated with some major complications were estimated using data on 5102 UKPDS patients (mean age 52.4 years at diagnosis). In-patient and out-patient costs were estimated using multiple regression analysis based on costs calculated from the length of admission multiplied by the average specialty cost and a survey of 3488 UKPDS patients' healthcare usage conducted in 1996-1997. Results Using the model, the estimate of the cost of first complications were as follows: amputation pound8459 (95% confidence interval pound5295, pound13 200); non-fatal myocardial infarction pound4070 (pound3580, pound4722); fatal myocardial infarction pound1152 (pound941, pound1396); fatal stroke pound3383 (pound1935, pound5431); non-fatal stroke pound2367 (pound1599, pound3274); ischaemic heart disease pound1959 (pound1467, pound2541); heart failure pound2221 (pound1690, pound2896); cataract extraction pound1553 (pound1320, pound1855); and blindness in one eye pound872 (pound526, pound1299). The annual average in-patient cost of events in subsequent years ranged from pound631 (pound403, pound896) for heart failure to pound105 (pound80, pound142) for cataract extraction. Non-in-patient costs for macrovascular complications were pound315 (pound247, pound394) and for microvascular complications were pound273 (pound215, pound343) in the year of the event. In each subsequent year the costs were, respectively, pound258 (pound228, pound297) and pound204 (pound181, pound255). Conclusions These results provide estimates of the immediate and long-term healthcare costs associated with seven diabetes-related complications.