OBJECTIVES: To estimate the 5-year cumulative costs of cardiovascular renal disease (CVRD) hospitalizations for type 2 diabetes (T2D) free of CVRD at baseline.

METHODS: Cohort study of all T2D patients free of CVRD (5-year history) as of January 1^st, 2014, identified and followed-up for 5 years within the French SNDS nationwide claims database. 5-year cumulative CRVD hospital costs for T2D patients without CVRD at baseline was estimated for each CVRD over time from the perspective of all payers.

RESULTS: From about 2 million T2D patients without cancer or transplantation, 76.5% were free of CVRD at baseline with a mean age of 65 years, 52% women, 46% T2D for more than four years and 7% of diabetic complications. For the whole cohort, the 5-year global cost of all CVRD hospitalizations was 3.875 billion € (B€) with an increase weakly exponential over time for CVRD manifestations. The 5-year cumulative hospital costs were 1.954 B€ for chronic kidney disease (CKD) and 1.169 B€ for heart failure (HF), respectively 6.6 and 4.0 times more costly than for myocardial infarction (MI) (0.295 B€), 3.2 and 1.9 times more costly than for stroke (0.614 B€), 2.8 and 1.7 time more costly than for peripheral arterial disease (PAD) (0.690 B€). Hospitalizations for HF or CKD together were 1.8 times more costly than for MI, stroke and PAD together (2.742 vs 1.549 B€); sum of hospital costs of each specific CVRD was 21.9% higher than the overall cost because some hospitalizations may involve 2 or more CVRD diagnoses when considering primary and associated diagnoses.

CONCLUSIONS: The 5-year global CRVD complication cumulative hospital cost in France was about 2 billion € for those without CVRD at baseline. HF and CKD hospitalizations together were twice as expensive than the MI, stroke and PAD complications together. This should encourage the development of specific preventive strategies.