Abstract

Objectives

This study aimed to estimate the direct and incremental healthcare costs associated with complications in people with diabetes and those without diabetes.

Methods

In this matched retrospective cohort study, adults with diabetes (n = 18 937) and controls (without diabetes) were identified from a linked administrative data set in Western Australia. Direct healthcare costs were estimated for 2021, with costs expressed in 2024 Australian Dollars (AUD). For each complication, the average cost per person and the incremental cost-difference between the average annual costs of people living with and without diabetes were computed.

Results

Complications accounted for about 15% of the total incremental costs of diabetes. Average annual costs attributable to diabetes, where individuals had ≥1 complication (51.4%), were AUD4629. The annual incremental costs were higher in people living with diabetes diagnosed with macrovascular complications (AUD5114), followed by metabolic (AUD4841) and microvascular (AUD4682) complications. The annual incremental cost in people living with diabetes diagnosed with at least 1 complication was higher in those with T2D (AUD5708) than in those with unspecified types of diabetes (AUD4325) and T1D (AUD4787). Annual incremental healthcare costs increased with an increase in the number of complications in people living with diabetes.

Conclusions

Complications, particularly vascular complications, are associated with substantial healthcare costs in people with diabetes. Timely and evidence-based interventions are needed to prevent or delay the development and progression of diabetes-related complications, particularly vascular complications, to drive cost savings and improve health and well-being.