Economic Burden of Type 1 Diabetes Mellitus After Disease Onset: A Claims Data Analysis
Author(s)
Denis Azabdaftari, MSc1, Klaus Bornholdt, Dr.1, Oliver Damm, DrPH1, Katrin Pegelow, Dr.1, Lena Hasemann, M.Sc2, Kylie Braegelmann, Dr.2, Bastian Surmann, M.Sc2, Julian Witte, MPH, MSc2, Olga Kordonouri, Prof. Dr.3.
1Sanofi-Aventis Deutschland GmbH, Berlin, Germany, 2Vandage GmbH, Bielefeld, Germany, 3Department of Diabetology, Endocrinology and General Pediatrics and Clinical Research, Children's and Adolescent Hospital “Auf der Bult”, Hannover, Germany.
1Sanofi-Aventis Deutschland GmbH, Berlin, Germany, 2Vandage GmbH, Bielefeld, Germany, 3Department of Diabetology, Endocrinology and General Pediatrics and Clinical Research, Children's and Adolescent Hospital “Auf der Bult”, Hannover, Germany.
OBJECTIVES: This study aimed to quantify the economic burden of Type 1 Diabetes Mellitus (T1DM) in Germany during the first three years after disease onset, focusing on healthcare resource utilization (HCRU), costs, and acute complications. Considering emerging therapies that may delay onset, age-stratified analyses were conducted to assess potential benefits of shifting diagnosis.
METHODS: A retrospective cohort study was conducted using claims data (covering 2017-2023 including pre-observation and follow-up period) from German statutory health insurance (~9 million insured). Incident T1DM cases were identified via ICD-10-codes and prescription data, and matched 1:10 with controls based on age, sex, region, index quarter, and Rx-Risk Score. The outcomes included HCRU (physician visits, hospitalizations, prescriptions) and total costs. Additional outcomes were T1DM-specific resource use, costs, and complications such as diabetic ketoacidosis (DKA) and hypoglycemia. Analyses were stratified by age group and time since diagnosis: onset-phase (first 12 months) and steady-state-phase (months 13-36).
RESULTS: Between 2018 and 2022 T1DM incidence rose from 9.20 (95%-CI:8.55,9.88) to 11.46 (95%-CI:10.76,12.19) per 100,000, with the highest rates among children and adolescents. Healthcare costs were significantly higher in T1DM patients than in controls across all age groups. Onset-phase costs peaked (mean €13,942; SD €17,067), primarily due to hospitalizations, before declining in steady-state phase year one (€8,003; SD €17,310) and year two (€7,625; SD €13,760). Control group costs remained stable between €1,500 and €1,700. Younger patients incurred higher T1DM-specific total cost with a peak at 0-7 years (€ 17.485; SD €5.625). Same is seen for cost of medical aids at onset (0-7 years: €5,634; SD €2,829). DKA rates were frequent at onset especially in younger patients but strongly declined in the steady-state period.
CONCLUSIONS: Incident T1DM imposes a substantial economic burden, especially in the first year post-diagnosis. Hospitalizations and medical aids are major cost drivers, with the highest burden observed in younger populations.
METHODS: A retrospective cohort study was conducted using claims data (covering 2017-2023 including pre-observation and follow-up period) from German statutory health insurance (~9 million insured). Incident T1DM cases were identified via ICD-10-codes and prescription data, and matched 1:10 with controls based on age, sex, region, index quarter, and Rx-Risk Score. The outcomes included HCRU (physician visits, hospitalizations, prescriptions) and total costs. Additional outcomes were T1DM-specific resource use, costs, and complications such as diabetic ketoacidosis (DKA) and hypoglycemia. Analyses were stratified by age group and time since diagnosis: onset-phase (first 12 months) and steady-state-phase (months 13-36).
RESULTS: Between 2018 and 2022 T1DM incidence rose from 9.20 (95%-CI:8.55,9.88) to 11.46 (95%-CI:10.76,12.19) per 100,000, with the highest rates among children and adolescents. Healthcare costs were significantly higher in T1DM patients than in controls across all age groups. Onset-phase costs peaked (mean €13,942; SD €17,067), primarily due to hospitalizations, before declining in steady-state phase year one (€8,003; SD €17,310) and year two (€7,625; SD €13,760). Control group costs remained stable between €1,500 and €1,700. Younger patients incurred higher T1DM-specific total cost with a peak at 0-7 years (€ 17.485; SD €5.625). Same is seen for cost of medical aids at onset (0-7 years: €5,634; SD €2,829). DKA rates were frequent at onset especially in younger patients but strongly declined in the steady-state period.
CONCLUSIONS: Incident T1DM imposes a substantial economic burden, especially in the first year post-diagnosis. Hospitalizations and medical aids are major cost drivers, with the highest burden observed in younger populations.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
RWD73
Topic
Economic Evaluation, Epidemiology & Public Health, Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity)