OBJECTIVES: Eye diseases affect about one-third of the diabetic population and their development can significantly increase both individual and health insurance costs. Our aim was to determine the annual health insurance treatment cost of diabetes with ophthalmic complications in Hungary.

METHODS: Data were derived from the financial database of the Hungarian National Health Insurance Fund Administration (NHIFA), for the year 2018. Data analysed included annual health insurance costs, patient numbers and cost distribution calculated for age groups and sex. The following cost categories were included into the study: general practice care, home care, in- and outpatient care, medical imaging, laboratory diagnostics, pharmaceuticals and medical aids. Patients with type 2 diabetes with ophthalmic complications were identified with the following code of the International Classification of Diseases 10^threvision: E1130.

RESULTS: In 2018, NHIFA spent 691.29 million Hungarian Forints (HUF) on the treatment of patients with retinopathy which equals to 2.56 million American Dollars (USD), or 2.17 million Euros (EUR). 52.1% of costs was spent on the treatment of male, 47.9% on female patients. The highest patient numbers were in outpatient care: 8,132 men (52.6%), 7,314 women (47.4%) in total 15,446 patients. Pharmaceuticals (71.7% of total health insurance costs in men, 69.5% in women), outpatient care (14.0% in men, 13.1% in women) and medical aids (5.8% in men, 8.1% in women) were the main cost drivers, while all other forms of medical care amounted to 8.5% in men and 9.3% in women. Annual health care treatment cost per patient (according to pharmaceutical usage) was 99,909 HUF (370 USD/313 EUR) in men and 98,899 HUF (366 USD/310 EUR) in women.

CONCLUSIONS: Pharmaceuticals were found to be the major cost drivers. Major cost drivers and average annual health insurance costs per patient showed no real difference between men and women.