Economic Implications of Improving Type 2 Diabetes Management in China
From Current Standards towards Optimized Scenarios
Undiagnosed, diabetes in China is associated with preventable complications and mortality as well as considerable costs. The current management of type 2 diabetes (T2D) in China appears to be far from optimal—only 26% of patients receive consistent treatment, and of those, only 40% attain adequate glycemic control. At a national level, T2D-related direct annual costs are estimated at ¥621Bn ($90.5Bn) under current patient management conditions. These annual national T2D costs include ¥593Bn in diabetes related complication costs and ¥28Bn in treatment costs (glucose lowering and CV risk factor regulating medications).
The CORE Diabetes Model (CDM) was used to quantify the possible benefits and cost savings that may be achieved by multiple strategies to improve T2D management in China in comparison to current T2D patient management standards. Findings from our modeling analysis indicate that optimal management can yield significant benefits to the Chinese health system.
As much as ¥212Bn ($30.9Bn) of annual complication costs could be saved under optimal T2D management conditions. Conditions would include immediate diagnosis after disease onset, glucose lowering treatment escalation at the guideline recommended target levels (HbA1c >= 7%), perfect patient adherence and cardiovascular risk factor control alongside guideline recommendations. These savings are offset in part by increased treatment costs of ¥107Bn with optimal treatment versus the current management but still result in an overall net savings of ¥106Bn.
Under optimal management conditions, a total of 1.26 million microvascular complications and 1.33 million macrovascular complications could annually be avoided in China, in comparison to current management. In addition, predictions from the CDM model demonstrated substantial reductions in mortality alongside improved scenario projections. In the general population, mortality risk could be reduced by 21.5%, 15.5% and 11.6% after 10, 20 and 30 years post-disease onset, and life expectancy improved by 3.21 years in individuals with optimal management.