OBJECTIVES: The aim is to assess the time course of medical care costs due to type 2 diabetes from the time of diagnosis through the first 8 following years (2008-2015). Specific and non-specific costs of diabetes are analyzed from a public payer perspective and constructed on the French health insurance medico-administrative database (SNIIRAM). METHODS:

Using information about 49 million individuals from the general scheme insurance database in 2008 (77% of the 64 million individuals insured by all French insurance schemes), we identified people aged 45 years and older who were newly treated for type 2 diabetes. Costs of all reimbursed expenditures were extracted per individual over 8 years. To estimate the cost attributable to type 2 diabetes, we first identify expenditure items specifically attributable to diabetes. For other expenditures, we use exact matching to identify a non-diabetic control group and to estimate the differential cost attributable to diabetes, based on the comparison between expenditures of the diabetic and non-diabetic populations. Then, we observe over 8 years the dynamics of the costs attributable to diabetes. RESULTS: We identify 220,000 persons who were newly treated for type 2 diabetes in 2008 (45 years and older). This provides an incidence rate of 1,160 per 100,000 insured persons. Among people with newly treated diabetes, 52% are men. The mean age is 64 years (62 years for men and 65 years for women). Based on this cohort, we aim to assess the change over time of overall cost and costs attributable to diabetes due to the natural history of the disease. CONCLUSIONS: Describing the impact of the natural history of the disease on the cost of type 2 diabetes on such a large cohort of patients will give policy maker a better understanding of how diabetes, its complications and health care affect expenditures over time.