Direct Costs of Diabetes Care in Pediatric Patients with Type 1 Diabetes in Greece


Background: Type 1 diabetes (T1D) is a chronic disease with increasing incidence and major impact on the health care costs. Aim: To estimate the direct cost of pediatric T1D in the Greek National Health System (NHS) and its distribution by service category. Methods: This is a retrospective cost-of-illness study, focusing on the direct costs from the healthcare system’s point of view. All patients aged 0 - 16 years, diagnosed with T1D, who were followed in the Diabetes Outpatients’ Clinic of the University Pediatric Department of one of the two main Pediatric Hospitals in Athens, for a two-year period (1st January 2011 to 31st December 2012) were included. Results: Total diabetes-related direct costs per person-year were estimated at €2,712 (95% CI 2468 - 2956). Diabetes healthcare provider and education visits including laboratory tests, accounted for only 7.6% of total costs. Cost for hospitalizations was only 1.7%. Medication costs were 17% of total costs and were the highest for multi-injection therapy. Supply costs accounted for 73.7% of the total costs and were the highest for insulin pump therapy (p = 0.000). 12.4% of patients were admitted yearly for diabetes related cause and the mean length of hospitalization was 0.18 days per person-year (95%CI: 0.05 - 0.3). Conclusion: This is a preliminary study based on a single institution’s data, which however constitutes a major referral center, thus dealing with a balanced sample of the Greek pediatric diabetic population. Considering that standards of diabetes care are common throughout the NHS, the management of patients in our hospital represents the common practice for pediatric diabetes in Greece. Data are suggesting that cost for hospitalization and outpatients’ care for T1D patients followed in the public sector was rather low compared to other countries, the medication cost was at similar or lower levels and the cost of supplies was generally higher.

Share and Cite:

Karachaliou, F. , Athanasakis, K. , Tsentidis, C. , Kitra, M. , Kyriopoulos, J. and Karavanaki, K. (2014) Direct Costs of Diabetes Care in Pediatric Patients with Type 1 Diabetes in Greece. Journal of Diabetes Mellitus, 4, 209-215. doi: 10.4236/jdm.2014.43030.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Tao, B.T. and Taylor, D.G. (2010) Economics of Type 1 Diabetes. Endocrinology Metabolism Clinics of North America, 39, 499-512.
[2] Icks, A., Rosenbauer, J., Rathmann, W., Haastert, B., Gandjour, A. and Giani, G. (2004) Direct Costs of Care in Germany for Children and Adolescents with Diabetes Mellitus in the Early Course after Onset. Journal of Pediatric Endocrinology and Metabolism, 17, 1551-1559.
[3] Bachle, C.C., Holl, R.W., Straβburger, K., Molz, E., Chernyak, N., Beyer, P., Schimmel, U., Rütschl, H., Seidel, J., Lepler, R., Holder, M., Rosenbauer, J., Icks, A., DPV Initiative German BMBF Competence Network Diabetes Mellitus (2012) Costs of Paediatric Diabetes Care in Germany: Current Situation and Comparison with the Year 2000. Diabetic Medicine, 29, 1327-1334.
[4] Ying, A.K., Lairson, D.R., Giardino, A.P., Bondy, M.L., Zaheer, I., Haymond, M.W. and Heptulla, R.A. (2011) Predictors of Direct Costs of Diabetes Care in Pediatric Patients with Type 1 Diabetes. Pediatric Diabetes, 12, 177-182.
[5] DCCT Research Group (1995) Resource Utilization and Costs of Care in the Diabetes Control and Complications Trial. Diabetes Care, 18, 1468-1478.
[6] Ricci, P., Chantry, M., Levy, B., Poutignat, N., Kusnik-Joinville, O., Raimond, V., Thammavong, N. and Weill, A. (2009) Couts des Soins Remboursés par L‘Assurance Maladie aux Personnes Traitées pour Diabète: études Entred 2001 et 2007. Bulletin épidemiologique Hebdomadaire, 42-43,464-469.
[7] Morgan, C., Peters, J.R., Dixon, S. and Currie, C.J. (2010) Estimates Costs of Acute Hospital Care for People with Diabetes in the United Kingdom: A Routine Record Linkage Study in a Large Region. Diabetic Medicine, 27, 1066-1073.
[8] Currie, C.J., Gale, E.A. and Poole, C.D. (2010) Estimation of Primary Care Treatment Costs and Treatment Efficacy for People with Type 1 and Type 2 Diabetes in the United Kingdom from 1997 to 2007. Diabetic Medicine, 27, 938-948.
[9] Kanavos, P., van der Aardweg, S. and Schurer W. LSE Health, London School of Economics (2012) Diabetes Expenditure, Burden of Disease and Management in 5 EU Countries.
[10] The Economist Intellegence Unit (2007) The Silent Epidemic: An Economic Study of Diabetes in Developed and Developing Countries. The Economist.
[11] Marchesini, G., Forlani, G., Rossi, E., Berti, A., De Rosa, M. and on Behalf of the ARNO Working Group (2011) The Direct Economic Cost of Pharmacologically-Treated Diabetes in Italy-2006. Nutrition, Metabolism & Cardiovascular Diseases, 21, 339-346.
[12] Osservatorio Arno Diabete (2011) ll Profilo Assistenziale Della Popolazione con Diabete. CINECA, Collana Rapporti Arno.
[13] Oliva, J., Lobo, F., Molina, B. and Monereo, S. (2004). Direct Health Care Costs of Diabetic Patients in Spain. Diabetes Care, 27, 2616-2621.
[14] Bachle, C., Haaster, B., Holl, R.W., Beyer, P., Grabert, M., Giani, G. and Icks, A. (2010) Inpatient and Outpatient Health Care Utilization of Children and Adolescents with Type 1 Diabetes before and after Introduction of DRGs. Experimental and Clinical Endocrinology Diabetes, 118, 644-648.

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.