SYSTEMATIC LITERATURE REVIEW OF THE ECONOMIC BURDEN OF TYPE 2 DIABETES IN ITALY: COST DRIVERS ACROSS TREATMENT-DEFINED POPULATIONS
Author(s)
Gaia Maria Luna Maglionico, MSc1, Nicoletta Grovale, Sr., MSc1, Marina Grifi, MSc2, Gianmarco Ventura, MSc1, Tatiana Simion, MSc3, Gianni Ghetti, MSc3, Marco Bellone, MSc3.
1Dexcom, Milano, Italy, 2Dexcom, Inc, Morges, Switzerland, 3AdRes HE&OR, Torino, Italy.
1Dexcom, Milano, Italy, 2Dexcom, Inc, Morges, Switzerland, 3AdRes HE&OR, Torino, Italy.
OBJECTIVES: To assess the economic burden of type 2 diabetes mellitus (T2DM) in Italy by characterizing healthcare costs across treatment-defined patient populations and identifying key cost drivers and factors associated with resource use.
METHODS: A systematic literature review was conducted in MEDLINE and Embase to identify Italian studies published between January 2015 and October 2025. Eligible studies included adults with T2DM treated with basal insulin, GLP-1 receptor agonists (GLP-1 RAs), or SGLT2 inhibitors. Costs and healthcare resource utilization were extracted across treatment-defined populations, including complications, hospitalizations, glucose monitoring, and specialist care. A narrative synthesis was presented, given heterogeneity.
RESULTS: A total of 58 studies were included. Annual per-patient costs varied widely across populations. In basal insulin-treated patients, the annual estimate was €2,254. In GLP-1 RA-treated populations, annual costs ranged from €1,580 in earlier studies to €5,241-€6,134 in more recent analyses stratified by adherence. In SGLT2 inhibitor-treated populations, costs ranged from €2,785-€3,014, increasing to €4,856-€4,952 with lower adherence. Complication-related costs represented the largest component of the economic burden. In basal insulin-treated patients, lifetime complication costs ranged from €82,000-€88,000, mainly driven by cardiovascular complications (€53,000), followed by renal (€12,300-13,700) and ophthalmic (~€6,000). In studies evaluating GLP-1 RA-treated populations, lifetime complication costs of ~€27,000 were reported, with cardiovascular complications remaining the main contributor. Evidence in SGLT2 inhibitor-treated populations indicated a lower burden of renal and cardiovascular complications, consistent with lower renal event rates. Hospitalization costs increased with clinical complexity. In basal insulin-treated patients, annual costs ranged from €72 (no comorbidities) to €3,506 (≥4 comorbidities). Annual monitoring and specialist care costs ranged from €791-€957 and €62-€1,133, respectively.
CONCLUSIONS: In Italy, T2DM costs are mainly driven by complications and hospitalizations across treatment-defined populations. Interventions improving disease control, care pathways, and glucose monitoring may contribute to reducing avoidable costs.
METHODS: A systematic literature review was conducted in MEDLINE and Embase to identify Italian studies published between January 2015 and October 2025. Eligible studies included adults with T2DM treated with basal insulin, GLP-1 receptor agonists (GLP-1 RAs), or SGLT2 inhibitors. Costs and healthcare resource utilization were extracted across treatment-defined populations, including complications, hospitalizations, glucose monitoring, and specialist care. A narrative synthesis was presented, given heterogeneity.
RESULTS: A total of 58 studies were included. Annual per-patient costs varied widely across populations. In basal insulin-treated patients, the annual estimate was €2,254. In GLP-1 RA-treated populations, annual costs ranged from €1,580 in earlier studies to €5,241-€6,134 in more recent analyses stratified by adherence. In SGLT2 inhibitor-treated populations, costs ranged from €2,785-€3,014, increasing to €4,856-€4,952 with lower adherence. Complication-related costs represented the largest component of the economic burden. In basal insulin-treated patients, lifetime complication costs ranged from €82,000-€88,000, mainly driven by cardiovascular complications (€53,000), followed by renal (€12,300-13,700) and ophthalmic (~€6,000). In studies evaluating GLP-1 RA-treated populations, lifetime complication costs of ~€27,000 were reported, with cardiovascular complications remaining the main contributor. Evidence in SGLT2 inhibitor-treated populations indicated a lower burden of renal and cardiovascular complications, consistent with lower renal event rates. Hospitalization costs increased with clinical complexity. In basal insulin-treated patients, annual costs ranged from €72 (no comorbidities) to €3,506 (≥4 comorbidities). Annual monitoring and specialist care costs ranged from €791-€957 and €62-€1,133, respectively.
CONCLUSIONS: In Italy, T2DM costs are mainly driven by complications and hospitalizations across treatment-defined populations. Interventions improving disease control, care pathways, and glucose monitoring may contribute to reducing avoidable costs.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE476
Topic
Clinical Outcomes, Economic Evaluation, Medical Technologies
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity)