Diabetes treatment costs China US$25bn per year

23 Nov 2010

Early Data from a study by the Chinese Diabetes Society of the Chinese Medical Association and the International Diabetes Federation shows 13% of China’s medical expenditure is directly caused by diabetes.

The study is a follow-up to one  recently published in the New England Journal of Medicine which found that China had twice as many people with diabetes than previously estimated.

China has the largest number of people with diabetes in the world at 92.4 million adults, followed by India with 50.8 million.[1]

The study, which reveals the social and economic impact of diabetes, also indicates that China can prevent dramatic increase of costs through effective treatment.

Key findings

Approximately 5,000 people were interviewed between January 2008 and August 2010 in 12 sites for this nationally representative study. Early results based on 1,920 responses from five sites reveal the following key findings:

  1. 13% of total medical expenditure in China is directly caused by diabetes, costing RMB 173.4 billion or US$25 billion. People with diabetes in China report 3 to 4 times more in-patient care, out-patient visits, and emergency room visits than people without diabetes of the same age and sex.
  2. These numbers will increase rapidly over the next 10 to 20 years when approximately 50 million Chinese with undiagnosed diabetes enter medical care, and when they and the 50 million Chinese with diagnosed diabetes start developing preventable diabetes complications such as stroke, blindness and kidney disease.
  3. Health expenditures for people in China who have had diabetes for 10 or more years are 460% higher than for people who have had diabetes for 1 to 2 years.
  4. Urban Chinese with diabetes are, so far, well-protected from the financial impact of diabetes that often causes destitution in countries without health insurance systems. 89% of people with diabetes in the five Chinese cities studied had health insurance. Only 11% of their total household income was spent on medical care. However, they spend 9 times more than people of the same age and sex without diabetes. Persons who have had diabetes for more than 10 years spent 22% of their current household income for healthcare.
  5. Diabetes prevalence is skyrocketing in China. People are getting diabetes at a younger age. However, China has a window of opportunity to prevent an epidemic of serious diabetes complications, which will increase spending dramatically. Currently, fewer than 5% of Chinese people with diabetes have experienced stroke, heart attack or heart failure. Less than 5% report kidney disease, eye surgery, or problems with their feet or legs. Half the people interviewed use glucose-lowering drugs but few use anti-hypertensives (16%), statins (1%), or aspirin (13%) which are inexpensive and highly effective and can together lower the risk of complications by 50% or more.
  6. More than half of Chinese men with diabetes smoke. Smoking increases the risk of diabetes complications by 2 to 4 times.

“The government of China is dedicated to diabetes care and prevention. We have introduced several programmes to raise public awareness of diabetes through education and train community-level healthcare professionals in diabetes care,” said Madame Kong Lingzhi, Deputy Director-General, Bureau of Disease Prevention and Control, Chinese Ministry of Health.

Underlining the importance of the IDF-CDS study on the social and economic impact of diabetes in China, IDF President Jean Claude Mbanya said its findings are further proof that diabetes represents a major barrier to development in low and middle-income countries, as well as emerging economic powerhouses.

Jean Claude Mbanya said, “The stellar economic development in countries such as China and India can come with a deadly price tag: lifestyle-related risk factors for type 2 diabetes, heart disease, cancers and other non-communicable disease (NCDs).

“This study is an eye-opener and a wake-up call to governments around the world. In order to protect future generations and ensure sustained economic success, countries must embrace development models that include plans for long-term public health.”

One of the main recommendations of the study is that the cost-effectiveness of existing medical treatments for diabetes be assessed in China. “This will further improve the efficiency of China’s healthcare system and make medicines more affordable for Chinese citizens,” said Prof nong Ji, President, Chinese Diabetes Society.

Combating diabetes

ThThe Chinese Ministry of Health has introduced large-scale diabetes awareness and education programmes, driven by the Chinese Diabetes Society.

On October 20 this year, a three-year project to train 100,000 community-level doctors across the country in diabetes prevention and treatment was launched. The project also features a web-based learning platform expected to deliver diabetes training to over 400,000 subscribers every year. Another project launched on October 5 will provide training in glucose management for 1,000 community-based healthcare providers.

In Tianjin, IDF runs a US$400,000 research project, named BRIDGES, in which the Tianjin Women and Children’s Health Centre aims to translate a proven gestational diabetes care protocol into daily practice.

To mark World Diabetes Day, China planned an impressive range of activities leading up to November 14, including a government-recognized Standard Injection Day, and diabetes screening and awareness programmes for the general public in 18 cities.

Monuments in more than 27 Chinese cities, such as the National Theatre (The Egg) in Beijing and the Oriental Pearl TV Tower in Shanghai, lit up in blue for the first time on November 14 to mark World Diabetes Day. The Chinese Diabetes Society has distributed 200,000 blue circle pins, blue measuring tapes and education booklets, 90,000 posters and flash broadcasts in the waiting room of railway stations in 343 cities across China. The diabetes blue circle is the international symbol for diabetes, like the red ribbon for HIV/AIDS.

“Help is needed from both inside and outside the country to prevent and control diabetes in China. We believe cooperation between IDF and CDS will improve diabetes prevention and control, not only in China but also around the world,” said Prof Ji.

Global solution

According to the IDF Diabetes Atlas, an estimated 285 million people have diabetes around the world. If nothing is done, this figure will reach 438 million by 2030.

In May 2010, United Nations member states unanimously voted in favour of a High Level Meeting of the UN General Assembly on Non-Communicable Diseases (NCDs) to be held in September 2011 in New York.

A similar UN summit on HIV/AIDS in 2001 proved to be a turning point in combating the disease, resulting in the setting up of global funding and a strong international civil-society movement.

“We are working to ensure the UN Summit on NCDs will take global action to a new level: raising the profile of too-long neglected diseases such as diabetes, mobilizing the international community, securing commitments from Heads of State, and sending a clear message to international donors on the importance of tackling NCDs,” stated Mbanya.

IDF is coordinating a programme of work, called the Diabetes Roadmap, that will produce and package arguments, evidence and solutions to ensure that the UN Summit translates into real change for the millions of people with diabetes worldwide.

On World Diabetes Day, IDF is launched A Call to Action on Diabetes, the first key activity from the Diabetes Roadmap programme, which will be the central advocacy tool for the global diabetes community in the lead up to the UN Summit.

“The global diabetes community must now move on from saying we have a problem to saying we know how to turn this epidemic around. We know what to do — we have the evidence, we have cost-effective solutions, we have the tools, we have the skills. And now, we are slowly seeing global political will for action,” said Mbanya.

“The time to act for diabetes is now.”

About World Diabetes Day

World Diabetes Day is celebrated on 14 November each year, a date chosen to mark the birthday of Sir Frederick Banting, one of the pioneers in diabetes research. It was introduced in 1991 by the International Diabetes Federation (IDF) and the World Health Organization (WHO) in response to the alarming rise in diabetes around the world. In 2007, the United Nations marked the Day for the first time with the passage of the United Nations World Diabetes Day Resolution in December 2006, which made the existing World Diabetes Day an official United Nations World Health Day.

World Diabetes Day is represented by the blue circle logo—the global symbol of diabetes. wwww.worlddiabetesday.org

Do you have diabetes?

Take the Blue Circle Test. Find out whether you could be at risk by taking the Blue Circle Test, a special online educational application developed by the International Diabetes Federation to showcase the risk factors for type 2 diabetes and the positive actions that individuals can take to reduce their risk.

The Test allows visitors to learn about the risk factors and establish a personalised risk profile with information about those factors that they consider relevant to themselves.




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