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1. Key messages

  • The economic burden of diabetes is high.
  • The high costs of diabetes are due to the disease being very common.
  • The costs of diabetes have increased since 2014.

2. Cost of health conditions defined based on medication use

The economic burden of diabetes is high

From the health conditions defined based on medication use included in the analysis for 2021, diabetes has by far the highest total medical costs, followed by Parkinson’s disease, and Alzheimer’s disease and other dementias. It should be noted that the costs for long-term care (e.g., nursing home care) is generally not part of the analysis, unless expenses are reimbursed by the compulsory health insurance.

Total medical costs by disease group for health conditions based on medication use, Belgium, 2021
Source: Own calculations based on data from the Intermutualistic Agency [1]

The high costs of diabetes are due to the disease being very common

The high costs of diabetes, compared to Parkinson’s disease and dementia, is mainly driven by the high prevalence of the disease. Parkinson’s disease and dementia are more costly to treat, but are also less prevalent than diabetes, so the total costs are relatively low compared to diabetes.

Total medical costs for health conditions defined based on medication use, by disease group, average medical costs per person, and number of cases, Belgium, 2021
Source: Own calculations based on data from the Intermutualistic Agency [1]

The costs of diabetes have increased since 2014

There has been an increase in the total costs for all three diseases in recent years, with the strongest increase in the costs of diabetes.

Trends in total medical costs for health conditions defined based on medication use by disease group, Belgium, 2013-2021
Source: Source: Own calculations based on data from the Intermutualistic Agency [1]

3. Read more

Discover the study protocol

Background

Data source

The costs of the different diseases are estimated based on different data sources. The best data source for each of the diseases is determined by a critical appraisal [2]).The data source for this analysis is the Permanent Sample of the Intermutualistic Agency. The 'permanent sample' is a database on health care utilisation. These data do not cover the total population, but only a representative selection. The sample includes data on consultations and visits to doctors, prescribed drugs, hospital admissions, nursing services, etc., [1, 3]

How we calculate medical costs of health conditions defined based on medication use

We estimate the incremental or additional costs attributable to each of the health conditions based on medication use. We adjust the costs based on factors like age, gender, reimbursement status (which gives us an idea of income or disability), and the region where a person lives. These factors can affect the chances of getting sick or having higher healthcare costs. Therefore, when we make these adjustments, we are essentially taking out the influence of things like age or gender. This helps us get a clearer picture of how much a particular disease alone is impacting the costs.

Definitions

Health conditions defined based on medication use
The Permanent Sample contains information about prescribed drugs. This information is used to determine who is likely to have a certain condition. For Parkinson’s disease, we use the Pharmaceutical Cost Group (FKG) as assigned by IMA [1]. For diabetes and dementia, we use our own algorithm based on IMA’s former ‘pseudodiagnoses’. For dementia, for example, we look at the prescription of anticholinesterases, a group of anti-dementia drugs.
Medical costs
In this analysis, medical costs are defined as direct healthcare costs. Direct healthcare costs encompass all the expenses associated with hospitalizations, outpatient visits, and medication use. Long-term care and psychiatric care are generally not part of the analysis, unless expenses are reimbursed by the compulsory health insurance. These costs can be covered directly by compulsory health insurance, reimbursed to patients after they have paid, or paid out-of-pocket.

References

  1. Metadata : db Échantillon Permantent(e) Steekproef (EPS), Intermutualistic Agency. https://metadata.aim-ima.be/nl/app/bdds/Ps 
  2. R. De Pauw, V. Gorasso, and B. Devleesschauwer, Belgian national burden of disease study. Guidelines for the calculation of DALYs in Belgium. Brussels, Belgium: Sciensano, 2022. https://www.sciensano.be/sites/default/files/bebod-protocol-20220210.pdf
  3. Onze gezondheidszorg evalueren via de ‘permanente steekproef'. RIZIV/INAMI. https://www.riziv.fgov.be/nl/publicaties/onze-gezondheidszorg-evalueren-via-de-permanente-steekproef

Please cite this page as: Sciensano. Cost of illness: health conditions based on medication use, Health Status Report, 22 Apr 2024, Brussels, Belgium, https://www.healthybelgium.be/en/health-status/cost-of-illness/health-conditions-based-on-medication-use