Cost-of-illness study of type 2 diabetes mellitus in Colombia.

OBJECTIVE To determine the per patient and overall cost of illness of type 2 diabetes mellitus (T2DM) in Colombia from Ministry of Health and societal perspectives. METHODS A published Markov transition model was adapted for Colombia, using the clinical expertise of a Colombian endocrinologist. Transition probabilities for the model were derived from an international literature review. A model was run for a time horizon of 42 years. Direct resources (drugs, laboratory, medical, hospital, other health care) were identified and cost was ascertained by using national price lists, international health care guidelines, and other Colombian studies or data from other countries. Indirect costs (work time lost) were calculated by using the human capital approach. Annual and lifetime direct and indirect costs, in 2007 U.S. dollars with a 5% discount rate, were determined on a per patient basis and projected to the overall Colombian population. Costs were clustered according to treatments and outcomes. RESULTS The estimated annual cost was $2.7 billion from the societal perspective and $921 million from the Ministry of Health perspective. The annual direct cost per patient was $288, and the indirect cost was $559 (total = $847). This cost was distributed across disease outcomes as follows: diabetes treatment (drugs), 47%; cardiac and coronary disease, 24%; stroke, 15%; amputation, 9%; nephropathy, 3%; retinopathy, 2%. Macrovascular complications made up 86% of the annual direct costs and 95% of the annual indirect costs of T2DM. CONCLUSIONS We estimated the annual cost of T2DM for Colombia from societal, Ministry of Health, and Colombian Health System perspectives. We also estimated annual direct cost per patient and the cost of treating diabetes and macrovascular complications. The economic burden is substantial and comparable to results for other countries. The model showed a logical disease progression.