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.