Annual cost of diabetes in Brazil could reach R$ 27 billion in 2030, says study

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Diabetes costs in Brazil already exceed US$ 2.1 billion (about R$ 10 billion), with US$ 633 million (about R$ 3.16 billion) for direct expenses and US$ 1.5 billion (or R$ 7.5 billion) for indirect expenses with the disease.

This sum could reach US$ 5.47 billion (about R$ 27.35 billion) by 2030, which is equivalent to a growth of 6.2% per year, if the number of people living with the disease increases 13 % until then. If the incidence of diabetes continues to rise in Brazil, this scenario could materialize even sooner, according to a survey.

The annual expenditure on the disease was estimated in a study by scientists from the FEA (Faculty of Economics and Administration) at USP and Unicamp. The data used are based on the year 2016, when the number of cases grew 13% compared to the previous three years.

The research, published on March 3 in the scientific journal Annals of Global Health, used data from the 2013 IBGE (Brazilian Institute of Geography and Statistics) National Health Survey on the population living with diabetes and adjusted the values ​​for 2016 based on in population growth in three years.

To calculate the direct costs of diabetes, which include medical expenses with hospitalizations, outpatient care and folk medicine, among others, the researchers consulted data from the SUS Hospital Information System (SIHSUS) and the Hospital and Ambulatory Information Communication System (CIHA). ) of hospitalizations in both the public and private sectors, whose main cause was diabetes mellitus.

According to the study, of the US$ 232.8 million (about R$ 1.16 billion) spent on hospitalization, the majority is for hospitalizations related to diabetes (81.4%), and the rest with diabetes as the cause. primary. Such expenses exceed the amount spent on outpatient care, of US$ 86 million (R$ 430 million), which shows how the late expenses of the disease are greater than the costs of primary care.

As for the breakdown by gender, men represent the largest part (53.3%) of hospitalization expenses for diabetes, with US$ 124.1 million (R$ 620.5 million), while hospitalization expenses by women are equivalent to US$ 108.6 million (R$ 543 million).

In terms of age group, people aged 55 and over represent 80.7%, or US$ 187.8 million (R$ 939 million), of total hospital expenses, and 86.1%, or US$ 74, 5 million (R$ 372 million), in outpatient expenses.

In addition to hospitalization data, expenditures on medicines at the popular pharmacy and on extra hospital expenses were analyzed, totaling US$ 314 million (R$ 1.57 billion).

Regarding indirect costs, the researchers analyzed three distinct factors that demonstrate the impact of diabetes on the lives of Brazilians: absenteeism, or the loss of productivity due to lack of work, premature death (calculated by years of life lost due to death or disability caused by illness) and early retirement. The calculations were based on the value of the minimum wage in 2013.

The largest share of indirect expenses with diabetes is related to premature death: US$ 1.18 billion (or R$ 5.9 billion, equivalent to 77.9%) of annual costs for this reason, with US$ 774.7 million (R$ 3.9 billion, or 65.6%) in men and US$ 408.8 million (R$ 2 billion, or 34.4%) in women.

According to Paula Pereda, professor in the Department of Economics at USP and lead author of the study, the burden of diabetes is greater in men because they generally take less care of themselves than women. “Even when the primary cause of morbidity [incapacidade] is diabetes, we see a more serious picture of men who seek care, and this proportion is also reflected in indirect costs, absenteeism, premature death and early retirement”, he explains.

For the 2030 projection, the authors evaluated how much the disease should affect the Brazilian economy and GDP (Gross Domestic Product) considering the individual expenditures of people living with diabetes both in per capita income and in the cost per patient.

Two scenarios were proposed, one more conservative, in which the incidence of diabetes cases would remain unchanged for the following 14 years (from 2016 to 2030), whose economic burden of the disease was estimated between US$ 2.34 billion and US$ 3.33 billion (about R$11.7 billion to R$16.6 billion). But, with the projection of a 13% growth in diabetes cases by 2030, the cost estimate raises this value to more than R$ 27 billion, almost three times the current expense.

The authors also emphasize that it is very likely that cases of diabetes in Brazil are underestimated, as there are still many deaths related to diabetes or complications from the disease that are not considered.

“Although the costs are already very high, we consider that they are already higher than we projected because we use a more conservative methodology. The indirect costs for society must be even greater, because diabetes directly affects the families of patients and also the market of work, in the context of productivity”, he says.

According to the latest edition of Atlas Diabetes 2021, diabetes cases grew by 16% in the world from 2019 to 2021, from 463 million to 537 million in the last year. The expectation is to reach 643 million patients in 2030, that is, an increase of 19%.

In Brazil, 9.14% of the adult population was living with diabetes in 2021, according to a survey by the Vigitel survey (Surveillance of Risk and Protection Factors for Chronic Diseases by Telephone Survey).

For Deborah Malta, a researcher at the UFMG School of Nursing and former coordinator of Vigitel (2006 to 2015), the study is relevant, as it manages to very fully calculate the costs of the disease. “Diabetes is often undervalued, but it has a remarkable systemic effect,” she says.

She points out that the disability caused by diabetes is already recognized as one of the main factors leading to premature death. “The scenario that the research estimates for 2030 actually arrived in 2019, because we are already seeing the consequence of the disability caused by diabetes with the increase in obesity and the decrease in life expectancy of the population”, she says.

The major flaw today in diabetes care in Brazil, according to the researcher, is the absence of solid prevention and health promotion programs, such as public policies for access to healthy food and encouragement of physical activities. “We know that there is an increase in the incidence and the mortality rate, which was in decline until 2016, 2017, has stagnated. [na taxa de 28,7 mortes por cem mil habitantes]. This is very worrying,” she says.

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