OBJECTIVES:

Diabetes mellitus type 2 (T2DM) is an established risk factor for vascular complications, cardiovascular events, and kidney failure. Prevalence of T2DM is expected to be as high as 8% in the year 2025. This will result in significant clinical impact and increases in healthcare expenditures, highlighting the need for well-informed reimbursement decisions. However, availability and consistent use of costs is limited. Here, we aim to systematically review available costing data for T2DM-related major cardiovascular and nephropathic events in the Netherlands, published in the last decade.

METHODS:

A systematic literature review was conducted to identify all available publications for Dutch costs for clinical events commonly found in T2DM patients. The PubMed database was searched for studies covering T2DM-related events using inclusion criteria. Information extracted from publications included costs, source of costs, study population, and costing perspective.

RESULTS:

Out of initially 214 papers, 29 were found to agree with the inclusion criteria. From these studies, 80 cost estimates for T2DM-related clinical events were identified, and arranged into tables. Twenty cost estimates were reported for MI. For stroke, 38 estimates for stroke were found. TIA and HF had two and eight estimates, respectively. Eleven cost estimates were found for renal failure-related events. Finally, eight cost estimates were reported for revascularisation.

CONCLUSIONS:

Many of studies covered MI and stroke, while only a limited number focussed on other T2DM-related events. The most expensive clinical events were found to be related to renal failure, most notably ESRD and dialysis. MI and TIA were found to be the least expensive in general. This systematic review showed that there is a substantial variation in reported cost estimates for the six major complications associated with T2DM. Costing of clinical events should be improved and preferably standardised, if accurate and consistent results in economic models are desired.