OBJECTIVES: Type 2 diabetes mellitus (T2DM) is one of the critical modifiable risk factors that contribute to the burden of cardiovascular disease (CVD). The purpose of this study was to predict the future health and economic burden of CVD among patients with T2DM in Australia from 2020 to 2030.

METHODS: A two-stage epidemiological dynamic multistate model with yearly cycles was developed to estimate the burden of the incident and prevalent CVD, including myocardial infarction (MI) stroke, and fatal cardiovascular events among Australians with T2DM aged 40 to 90 years from 2020-2030. The primary prevention population estimated the risk of developing the first CVD events using the Pooled Cohort Equations, while for the secondary prevention population, the risks of MI and/or stroke were obtained from the REACH registry. The main outcomes were cardiovascular events, years of life lived (YLL), quality-adjusted life years (QALYs), total healthcare costs and lost productivity costs. Costs and utilities were obtained from published sources. All outcomes were discounted at 5% per annum. The study was conducted from the healthcare and societal perspectives.

RESULTS: Over the study period, the model predicts total of 241,979 and 5,000,789 (4,774,248 for MI and 226,541 for stroke) of fatal and non-fatal cardiovascular events, respectively among patients with T2DM. The total YLL and QALYs among patients with T2DM and CVD are projected to be 18,057,447 and 8,291,672, respectively. The model also estimates that the total healthcare costs and productivity losses costs of managing T2DM and CVD will be AUD 421.15 billion and AUD 577.04 billion, respectively.

CONCLUSIONS: Considering its aging population and epidemiological transition, CVD prevalence is increasing in Australia. Also, the burden has a significant impact on the future economic, especially in relation to lost productivity. Therefore, population-based strategies are needed to curb the burden of CVD among patients with T2DM.