OBJECTIVES: The analysis aimed to quantify the number and costs of patients with type 2 diabetes and atherosclerotic cardiovascular disease from the Italian National Health Service (NHS) perspective.

METHODS: A Cost of Illness (CoI) model was developed to estimate the economic burden associated with diabetes and established atherosclerotic cardiovascular disease or risk factors for atherosclerotic cardiovascular disease. Data were extrapolated from the administrative database of the Marche Region and specific inclusion criteria for enrolling patients were adapted from DECLARE–TIMI 58 clinical trial. NHS perspective (drugs, hospitalizations, monitoring cost) and 1 and 4-year time horizons were considered.

RESULTS: The analysis estimated a total number of 92,205 diabetic Patients in Marche region in 2014. Of these, 66.306 patients (5.9% of the resident population) with established atherosclerotic cardiovascular disease (13,104 patients) or risk factors for atherosclerotic cardiovascular disease (53,202 patients). The annual expenditure associated with patients analysed amounted to over € 3.8 billion (average cost per patient € 1,480) in Italy. Of these, 52% was associated with hospitalizations. Considering a 4-year time horizon, the overall economic burden rises to over € 11.8 billion per year with an average cost per patient of € 4,545. Stratifying patients between patients hospitalized for heart failure and patients not hospitalized for heart failure, the average annual cost per patient was equal to € 15,896 and equal to € 3,998 respectively.

CONCLUSIONS: An important epidemiological and economic burden associated with type 2 diabetes patients were estimated from the analysis due to the disease and the associated comorbidities. The ability to prevent comorbidity risks, especially cardiovascular ones, represents not only a clinical advantage but also a positive reduction in expenditure. Early and effective intervention represents the best strategy to avoid or slow down the evolution of complications of the disease.