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.