The Economic Burden of Macrovascular Complications of Diabetes in Algeria

OBJECTIVES: Diabetes represents a major public health challenge, both in terms of prevalence and complications severity, ending-up with a significant financial impact. The objective of this study is to estimate the diabetes management cost and related macrovascular complications amongst type II diabetics, simulated evolution of cost burden outlook over 5 years and the expected benefits of adopting an effective preventive strategy.

METHODS: Our study has been carried-out at 3 hospital departments in Algiers, and is underpinned by a multicenter retrospective and prospective pharmaco-economic approach, involving 425 balanced or complicated diabetics. A real-world data collection based on therapeutic and diagnostic strategies adopted and their relating costs, mainly applied in health care private sector, allowed to make an annual cost estimate of balanced diabetes and associated diabetic macroangiopathy. Pharmaco-economic modeling allowed to extrapolate the results to a national scale, evaluate the savings generated by the lifestyle changes and the addition of metformin in prediabetics and to predict their evolution over 5-year horizon.

RESULTS: The study results show that balanced and complicated diabetes related costs constitute a significant annual expense amounting to more than 19000 USD at maximum. Expenditures are expected to increase within five-year period, and to be amounting to 16046 USD maximum, amongst diabetic population (expected 4 million by 2027). Thus a cost increase of 8223 USD due to conversion of prediabetes into diabetes in the predisposed groups of population. Nevertheless, a substantive cost reduction amounting to 2602 USD can be achieved by implementing a strategy based on lifestyle intervention with addition of metformin amongst prediabetics.

CONCLUSIONS: This study highlights the considerable economic burden associated with diabetes and its complications in Algeria and underscores the need to invest more efforts in prevention, lifestyle, harmonization of private sector prices and increase national real-world-evidence studies, in order to optimize care and implement effective prevention strategies.