Economic Burden Associated With Type 2 Diabetes Mellitus in France: An Update From the National Insurance Claim Database
Author(s)
Bruno Guerci, Prof. Dr.1, christele blanc-bisson, Dr.2, Eric Vicaut, Prof. Dr.3, Gérard André De Pouvourville, PhD4, Bruno DETOURNAY, MA, MBA, MSc, MD5, Corinne Emery, MS5, Isabelle Bureau, -5, Taos Ihaddadene-Salzgeber, PharmD6, Fleur Levrat Guillen, PharmD7, Jean-Pierre Riveline, PhD, MD8.
1CHRU Nancy, Brabois Hospital, University of Lorraine, Vandoeuvre-les-Nancy, France, 2Département de Médecine Générale, Bordeaux University, Bordeaux, France, 3URC HUSLS, Lariboisière Fernand Vidal Hospital, Paris, France, 4Departament of Economics, ESSEC Business School, Paris, France, 5CEMKA, Bourg-la-Reine, France, 6Abbott, Rungis, France, 7Abbott Diabetes Care, Maidenhead, United Kingdom, 8Lariboisière Hospital AP-HP, Paris, France.
1CHRU Nancy, Brabois Hospital, University of Lorraine, Vandoeuvre-les-Nancy, France, 2Département de Médecine Générale, Bordeaux University, Bordeaux, France, 3URC HUSLS, Lariboisière Fernand Vidal Hospital, Paris, France, 4Departament of Economics, ESSEC Business School, Paris, France, 5CEMKA, Bourg-la-Reine, France, 6Abbott, Rungis, France, 7Abbott Diabetes Care, Maidenhead, United Kingdom, 8Lariboisière Hospital AP-HP, Paris, France.
OBJECTIVES: Type 2 diabetes mellitus (T2DM) management in France has advanced over the past decade through novel technologies and treatments. This study aims to update T2DM's economic burden in France.
METHODS: This retrospective cross-sectional study analysed a representative sample of T2DM adults in France using the ESND claims database (Echantillon National des Données de Santé). Adults were identified in 2021 and 2022 based on antidiabetic drug reimbursement, long-term disease, or hospital diagnoses (ICD-10 codes). A control group of non-diabetic patients (1:3 ratio) was matched using a propensity score. Direct healthcare costs were estimated including reimbursement and out-of-pocket health expenditures (Euros 2022). Comparative cost analysis was performed on the entire T2DM population according to treatment line. Results were compared to similar data previously generated in 2013.
RESULTS: Cost analysis included 80,127 T2DM adults and 237,607 matched individuals without diabetes., Annual medical expenditures were €6,614 per T2DM adults (€6,506 in 2013), versus €3,797 (€3,668 in 2013) for controls, representing a 1.74-fold higher cost for people with T2DM. Annual cost difference between groups was €2,817 per individual, mainly driven by hospitalizations (+€864), medication (+€802), and nursing care (+€448). The annual cost increase between groups for medical device was +€352. Annual per capita costs were lowest for T2DM individuals on glucose-lowering medications (€5,053) and highest for those undergoing intensive insulin treatment (€13,913).
CONCLUSIONS: Extrapolating these findings to the whole diagnosed T2DM population in France, direct costs would exceed €11.3 billion. The rise in total direct costs related to T2DM management reflects the increasing prevalence of the disease, while highlighting the relative effectiveness of healthcare cost containment policies in France. New diabetes technologies and treatments should contribute to reducing the economic burden of the disease, particularly by addressing key cost drivers such as hospitalizations.
METHODS: This retrospective cross-sectional study analysed a representative sample of T2DM adults in France using the ESND claims database (Echantillon National des Données de Santé). Adults were identified in 2021 and 2022 based on antidiabetic drug reimbursement, long-term disease, or hospital diagnoses (ICD-10 codes). A control group of non-diabetic patients (1:3 ratio) was matched using a propensity score. Direct healthcare costs were estimated including reimbursement and out-of-pocket health expenditures (Euros 2022). Comparative cost analysis was performed on the entire T2DM population according to treatment line. Results were compared to similar data previously generated in 2013.
RESULTS: Cost analysis included 80,127 T2DM adults and 237,607 matched individuals without diabetes., Annual medical expenditures were €6,614 per T2DM adults (€6,506 in 2013), versus €3,797 (€3,668 in 2013) for controls, representing a 1.74-fold higher cost for people with T2DM. Annual cost difference between groups was €2,817 per individual, mainly driven by hospitalizations (+€864), medication (+€802), and nursing care (+€448). The annual cost increase between groups for medical device was +€352. Annual per capita costs were lowest for T2DM individuals on glucose-lowering medications (€5,053) and highest for those undergoing intensive insulin treatment (€13,913).
CONCLUSIONS: Extrapolating these findings to the whole diagnosed T2DM population in France, direct costs would exceed €11.3 billion. The rise in total direct costs related to T2DM management reflects the increasing prevalence of the disease, while highlighting the relative effectiveness of healthcare cost containment policies in France. New diabetes technologies and treatments should contribute to reducing the economic burden of the disease, particularly by addressing key cost drivers such as hospitalizations.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE355
Topic
Economic Evaluation, Epidemiology & Public Health, Medical Technologies
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity), No Additional Disease & Conditions/Specialized Treatment Areas