Societal Costs of Diabetes Mellitus 2025 and 2040—Forecasts Based on Real World Cost Evidence and Observed Epidemiological Trends in Denmark


Aim: The objective is to contribute with real world evidenced economic forecasts of diabetes attributable costs in 2025 and 2040 differentiated according to patients’ morbidity status which is a novel approach within forecasting. Methods: Method of forecasting is based on an annual calendar year prediction of diabetes attributable costs by using the BOX-model, an established and tested epidemiological transition-state model. The study population includes all Danish diabetes patients presented in 2011 (N = 318,729) according to the Danish National Diabetes Register. Forecasting is based on individual patient data from 2000 to 2011 for incidence, mortality, patterns of morbidity and complication rates combined with demographic population projections from Statistics Denmark. The 2011 estimation of diabetes attributable costs were applied to the epidemiological framework. Forecasting was performed for three different epidemiological scenarios. Results: Our three epidemiological scenarios indicate that within the shorter time span increases in the prevalent population are difficult to change primarily due to the already achieved historic improvements in diabetes mortality and morbidity. These will approximately double societal costs of diabetes in the next 10 years assuming current trends in morbidity and mortality are maintained. The resulting diabetes population will incur three times current costs in 2040. A 20% reduction in cost per PYRS shows how the relative distribution of patients with complications is expected to change over time with patients living better with their disease and hence incur a lower demand for health and nursing care services.

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Sortsø, C. , Emneus, M. , Green, A. , Jensen, P. and Eriksson, T. (2015) Societal Costs of Diabetes Mellitus 2025 and 2040—Forecasts Based on Real World Cost Evidence and Observed Epidemiological Trends in Denmark. Modern Economy, 6, 1150-1166. doi: 10.4236/me.2015.610109.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] World Health Organization (2011) Global Status Report on Noncommunicable Diseases 2010—Description of the Global Burden of NCDs, Their Risk Factors and Determinants. World Health Organization.
[2] World Health Organization (2015) Diabetes Fact sheet.
[3] European Diabetes Leadership Forum (2012) The Diabetes Epidemic and Its Impact on Europe.
[4] Association, A.D. (2013) Economic Costs of Diabetes in the U.S. in 2012. Diabetes Care, 36, 1033-1046.
[5] Robert, H. and Blank, V.B. (2013) Comparative Health Policy. 4 Edition, Palgrave Macmillan, New York.
[6] Mayega, R.W., et al. (2013) Diabetes and Pre-Diabetes among Persons Aged 35 to 60 Years in Eastern Uganda: Prevalence and Associated Factors. PLoS ONE, 8, e72554.
[7] Ning, G. and Bloomgarden, Z. (2013) Diabetes in China: Prevalence, Diagnosis, and Control. Journal of Diabetes, 5, 372.
[8] Bhowmik, B.A.F., My Diep, L., Binte Munir, S., Wright, E., Mahmood, S., Khan, A.K.A. and Hussain, A. (2013) Increasing Prevalence of Type 2 Diabetes in a Rural Bangladeshi Population: A Population Based Study for 10 Years. Diabetes and Metabolism Journal, 37, 46-53.
[9] Green, A. (2008) Diabetes Mellitus i Danmark 1997-2006—Epidemiologiske Analyser. Institut for Sundhedstjenesteforskning, Odense, Denmark.
[10] Maruthur, N.M. (2013) The Growing Prevalence of Type 2 Diabetes: Increased Incidence or Improved Survival? Current Diabetes Reports, 13, 786-794.
[11] Green, A.S.C., Jensen, P.B. and Emneus, M. (2015) Incidence, Morbidity, Mortality, and Prevalence of Diabetes in Denmark, 2000-2011: Results from the Diabetes Impact Study 2013. Dove Press, London.
[12] Gillies, C.L., Lambert, P.C., Abrams, K.R., Sutton, A.J., Cooper, N.J., Hsu, R.T., Davies, M.J. and Khunti, K. (2008) Different Strategies for Screening and Prevention of Type 2 Diabetes in Adults: Cost Effectiveness Analysis. BMJ, 336, 1180-1185.
[13] Fazeli Farsani, S., van der Aa, M.P., van der Vorst, M.M.J., Knibbe, C.A.J. and de Boer, A. (2013) Global Trends in the Incidence and Prevalence of Type 2 Diabetes in Children and Adolescents: A Systematic Review and Evaluation of Methodological Approaches. Diabetologia, 56, 1471-1488.
[14] Patterson, C.C., Dahlquist, G.G., Gyürüs, E., Green, A. and Soltész, G. (2009) Incidence Trends for Childhood Type 1 Diabetes in Europe during 1989-2003 and Predicted New Cases 2005-20: A Multicentre Prospective Registration Study. The Lancet, 373, 2027-2033.
[15] Rosella, L.C., Lebenbaum, M., Fitzpatrick, T., O’Reilly, D., Wang, J., Booth, G.L., et al. (2015) Impact of Diabetes on Healthcare Costs in a Population-Based Cohort: A Cost Analysis. Diabetic Medicine, Epub ahead of Print.
[16] Sortso, C., Green, A., Jensen, P.B. and Emneus, M. (2015) Societal Costs of Diabetes Mellitus in Denmark. Diabetic Medicine, In Preperation.
[17] Astolfi, R., Lorenzoni, L. and Oderkirk, J. (2012) A Comparative Analysis of Health Forecasting Methods. OECD, France, 121.
[18] King, H., Aubert, R.E. and Herman, W.H. (1998) Global Burden of Diabetes, 1995-2025: Prevalence, Numerical Estimates, and Projections. Diabetes Care, 21, 1414-1431.
[19] Bagust, A., Hopkinson, P.K., Maslove, L. and Currie, C.J. (2002) The Projected Health Care Burden of Type 2 Diabetes in the UK from 2000 to 2060. Diabetic Medicine, 19, 1-5.
[20] Huang, E.S., Basu, A., O’Grady, M., Capretta, J.C., et al. (2009) Projecting the Future Diabetes Population Size and Related Costs for the US. Diabetes Care, 32, 2225-2229.
[21] Mainous, A.G., Baker, R., Koopman, R.J., et al. (2007) Impact of the Population at Risk of Diabetes on Projections of Diabetes Burden in the United States: An Epidemic on the Way. Diabetologia, 50, 934-940.
[22] Tunceli, K., Zeng, H.W., Habib, Z.A. and Williams, L.K. (2009) Long-Term Projections for Diabetes-Related Work Loss and Limitations among US Adults. Diabetes Research and Clinical Practice, 83, e23-e25.
[23] Green, A., Christansen, T., Bjork, S., Kristensen, J.K., et al. (2006) Type 1 Diabetes in Denmark Year 2001.
[24] Green, A., Christansen, T., Bjork, S., Kristensen, J.K., et al. (2006) Type 2 Diabetes in Denmark Year 2001. Odense.
[25] Thygesen, L.C. and Ersboll, A.K. (2011) Danish Population-Based Registers for Public Health and Health-Related Welfare Research: Introduction to the Supplement. Scandinavian Journal of Public Health, 39, 8-10.
[26] Association, D.D. (2013) Project: Diabetes Impact Study 2013. 2015 14-SEP-2015 16-SEP-2015.
[27] Green, A., Sortso, C., Jensen, P.B. and Emneus, M. (2015) Validation of the Danish National Diabetes Register. Journal of Clinical Epidemiology, 7, 5-15.
[28] Briggs, A., Claxton, K. and Sculpher, M. (2006) Decision Modelling for Health Economic Evaluation. Oxford University Press, New York.
[29] Denmark, S. (2015) Population Projection 2014-2040 (Database on the Internet).
[30] Eng, D.S. and Lee, J.M. (2013) The Promise and Peril of Mobile Health Applications for Diabetes and Endocrinology. Pediatric Diabetes, 14, 231-238.
[31] Edwards, D., Noyes, J., Lowes, L., Spencer, L.H. and Gregory, J.W. (2014) An Ongoing Struggle: A Mixed-Method Systematic Review of Interventions, Barriers and Facilitators to Achieving Optimal Self-Care by Children and Young People with Type 1 Diabetes in Educational Settings. BMC Pediatrics, 14, 228.
[32] Danske Regioner, F., Ministeriet for Sundhed og Forebyggelse (2012) Lobende offentliggorelse af produktivitet i sygehussektoren. (VIII delrapport). Udviklingen fra 2010 til 2011.
[33] Denmark, S. (2012) Plejeog Aldreboliger 2012. Sociale forhold, sundhed og retsvasen. 2012 16-SEP-2015.
[34] Caro, J.J., Briggs, A.H., Siebert, U. and Kuntz, K.M. (2012) Modeling Good Research Practices—Overview: A Report of the ISPOR-SMDM Modeling Good Research Practices Task Force-1. Value in Health, 15, 796-803.
[35] Ministeriet-sundhedogforebyggelse. DRG-leksikon, 2012.
[36] Kristensen, T., Olsen, K.R., Sortso, C., Ejersted, C., Thomsen, J.L. and Halling, A. (2013) Resources Allocation and Health Care Needs in Diabetescare in Danish GP Clinics. Health Policy, 113, 206-215.
[37] Yeaw, J., Lee, W.C., Aagren, M. and Christensen, T. (2012) Cost of Self-Monitoring of Blood Glucose in the United States among Patients on an Insulin Regimen for Diabetes. Journal of Managed Care Pharmacy, 18, 21-32.
[38] Association TDD (2010)
[39] Sundhedsstyrelsen. Type 2-Diabetes—Medicinsk teknologivurdering af screening, diagnostik og behandling. Danmark: Sundhedsstyrelsen, 2003.
[41] Russel, L., Suh, D. and Safford, M. (2005) Time Requirement or Diabetes Self-Management, Too Much for Many? Journal of Family Practice, 54, 52-56.
[42] Russel, L. (2009) Completing Costs, Patient’s Time. Medical Care, 47, 89-93.

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