Costs and its drivers for diabetes mellitus type 2 patients in France and Germany: a systematic review of economic studies

Abstract Background Type 2 diabetes represents an increasingly critical challenge for health policy worldwide. It absorbs massive resources from both patients and national economies to sustain direct costs of the treatment of type 2 diabetes and its complications and indirect costs related to work l...

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Main Authors: Constance Stegbauer, Camilla Falivena, Ariadna Moreno, Anna Hentschel, Magda Rosenmöller, Tim Heise, Joachim Szecsenyi, Freimut Schliess
Format: Article
Language:English
Published: BMC 2020-11-01
Series:BMC Health Services Research
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12913-020-05897-w
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spelling doaj-86648e6b5edd455ca0a6d88cad5aaf522020-11-25T04:03:17ZengBMCBMC Health Services Research1472-69632020-11-0120111210.1186/s12913-020-05897-wCosts and its drivers for diabetes mellitus type 2 patients in France and Germany: a systematic review of economic studiesConstance Stegbauer0Camilla Falivena1Ariadna Moreno2Anna Hentschel3Magda Rosenmöller4Tim Heise5Joachim Szecsenyi6Freimut Schliess7aQua Institute for Applied Quality Improvement and Research in Health Care GmbHHealth & Not for Profit Division, CERGAS, SDA Bocconi School of Management GovernmentsCRHIM - Center for Research in Healthcare Innovation Management, IESE Business School - University of NavarraaQua Institute for Applied Quality Improvement and Research in Health Care GmbHCRHIM - Center for Research in Healthcare Innovation Management, IESE Business School - University of NavarraProfilaQua Institute for Applied Quality Improvement and Research in Health Care GmbHProfilAbstract Background Type 2 diabetes represents an increasingly critical challenge for health policy worldwide. It absorbs massive resources from both patients and national economies to sustain direct costs of the treatment of type 2 diabetes and its complications and indirect costs related to work loss and wages. More recently, there are innovations based on remote control and personalised programs that promise a more cost-effective diabetes management while reducing diabetes-related complications. In such a context, this work attempts to update cost analysis reviews on type 2 diabetes, focusing on France and Germany, in order to explore most significant cost drivers and cost-saving opportunities through innovations in diabetes care. Although both countries approach care delivery differently, France and Germany represent the primary European markets for diabetes technologies. Methods A systematic review of the literature listed in MEDLINE, Embase and EconLit has been carried out. It covered interventional, observational and modelling studies on expenditures for type 2 diabetes management in France or Germany published since 2012. Included articles were analysed for annual direct, associated and indirect costs of type 2 diabetes patients. An appraisal of study quality was performed. Results were summarised narratively. Results From 1260 records, the final sample was composed of 24 papers selected according to predefined inclusion/exclusion criteria. Both France and Germany revealed a predominant focus on direct costs. Comparability was limited due to different study populations and cost categories used. Indirect costs were only available in Germany. According to prior literature, reported cost drivers are hospitalisation, prescriptions, higher HbA1c and BMI, treatment with insulin and complications, all indicators of disease severity. The diversity of available data and included costs limits the results and may explain the differences found. Conclusions Complication prevention and glycaemic control are widely recognized as the most effective ways to control diabetes treatment costs. The value propositions of self-based supports, such as hybrid closed-loop metabolic systems, already implemented in type 1 diabetes management, are the key points for further debates and policymaking, which should involve the perspectives of caregivers, patients and payers.http://link.springer.com/article/10.1186/s12913-020-05897-wCostDiabetes mellitus type 2FranceGermanyAutomated insulin delivery
collection DOAJ
language English
format Article
sources DOAJ
author Constance Stegbauer
Camilla Falivena
Ariadna Moreno
Anna Hentschel
Magda Rosenmöller
Tim Heise
Joachim Szecsenyi
Freimut Schliess
spellingShingle Constance Stegbauer
Camilla Falivena
Ariadna Moreno
Anna Hentschel
Magda Rosenmöller
Tim Heise
Joachim Szecsenyi
Freimut Schliess
Costs and its drivers for diabetes mellitus type 2 patients in France and Germany: a systematic review of economic studies
BMC Health Services Research
Cost
Diabetes mellitus type 2
France
Germany
Automated insulin delivery
author_facet Constance Stegbauer
Camilla Falivena
Ariadna Moreno
Anna Hentschel
Magda Rosenmöller
Tim Heise
Joachim Szecsenyi
Freimut Schliess
author_sort Constance Stegbauer
title Costs and its drivers for diabetes mellitus type 2 patients in France and Germany: a systematic review of economic studies
title_short Costs and its drivers for diabetes mellitus type 2 patients in France and Germany: a systematic review of economic studies
title_full Costs and its drivers for diabetes mellitus type 2 patients in France and Germany: a systematic review of economic studies
title_fullStr Costs and its drivers for diabetes mellitus type 2 patients in France and Germany: a systematic review of economic studies
title_full_unstemmed Costs and its drivers for diabetes mellitus type 2 patients in France and Germany: a systematic review of economic studies
title_sort costs and its drivers for diabetes mellitus type 2 patients in france and germany: a systematic review of economic studies
publisher BMC
series BMC Health Services Research
issn 1472-6963
publishDate 2020-11-01
description Abstract Background Type 2 diabetes represents an increasingly critical challenge for health policy worldwide. It absorbs massive resources from both patients and national economies to sustain direct costs of the treatment of type 2 diabetes and its complications and indirect costs related to work loss and wages. More recently, there are innovations based on remote control and personalised programs that promise a more cost-effective diabetes management while reducing diabetes-related complications. In such a context, this work attempts to update cost analysis reviews on type 2 diabetes, focusing on France and Germany, in order to explore most significant cost drivers and cost-saving opportunities through innovations in diabetes care. Although both countries approach care delivery differently, France and Germany represent the primary European markets for diabetes technologies. Methods A systematic review of the literature listed in MEDLINE, Embase and EconLit has been carried out. It covered interventional, observational and modelling studies on expenditures for type 2 diabetes management in France or Germany published since 2012. Included articles were analysed for annual direct, associated and indirect costs of type 2 diabetes patients. An appraisal of study quality was performed. Results were summarised narratively. Results From 1260 records, the final sample was composed of 24 papers selected according to predefined inclusion/exclusion criteria. Both France and Germany revealed a predominant focus on direct costs. Comparability was limited due to different study populations and cost categories used. Indirect costs were only available in Germany. According to prior literature, reported cost drivers are hospitalisation, prescriptions, higher HbA1c and BMI, treatment with insulin and complications, all indicators of disease severity. The diversity of available data and included costs limits the results and may explain the differences found. Conclusions Complication prevention and glycaemic control are widely recognized as the most effective ways to control diabetes treatment costs. The value propositions of self-based supports, such as hybrid closed-loop metabolic systems, already implemented in type 1 diabetes management, are the key points for further debates and policymaking, which should involve the perspectives of caregivers, patients and payers.
topic Cost
Diabetes mellitus type 2
France
Germany
Automated insulin delivery
url http://link.springer.com/article/10.1186/s12913-020-05897-w
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