Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 3 (3), A83

Employer-paid Nonmedical Costs for Patients With Diabetes and End-Stage Renal Disease


Employer-paid Nonmedical Costs for Patients With Diabetes and End-Stage Renal Disease

Sachin J Kamal-Bahl et al. Prev Chronic Dis.


Introduction: Disease conditions such as end-stage renal disease (ESRD), which have severe consequences of disability and mortality, can generate substantial costs for large employers providing life insurance and disability insurance benefits. This study is the first to examine such disease-related nonmedical costs for employers and models the following employer-paid costs for ESRD in patients with diabetes: 1) life insurance benefits, 2) disability benefits, and 3) cost of replacing a worker.

Methods: We simulated a hypothetical cohort of 10,000 individuals with the age and sex distribution of a typical employee population in the United States. Data sources for the model parameters included the United States Renal Data System and proprietary life insurance and disability insurance claims databases. In addition, we used published information to identify the structures of typical employee benefits programs and annual salary information and to estimate the cost of replacing lost workers.

Results: The study estimated that employers may incur life insurance costs of 55,055 dollars per ESRD-related death, disability insurance costs of 31,671 dollars per ESRD-related disability, and worker replacement costs of 27,869 dollars per ESRD-related lost worker. Overall, the total monthly cost per employee with ESRD and diabetes was 5439 dollars.

Conclusion: Our study finds that, other than the large direct medical costs documented in literature, ESRD onset also results in substantial nonmedical costs for employers. As employers continue to debate changes in the structure of future health plan benefits to reduce health care costs, they should consider potential indirect cost savings of providing affordable access to medical care that prevents or delays disability and mortality in their workers.

Similar articles

See all similar articles

Cited by 8 PubMed Central articles

See all "Cited by" articles


    1. U.S. Renal Data System: USRDS 2001 annual data report: atlas of end-stage renal disease in the United States. Bethesda (MD): National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2001.
    1. Manninen DL, Dong FB, Dasbach EJ, Carides GW, Herman WH, Collins AJ. The longitudinal cost of end-stage renal disease in persons with diabetes in the United States. J Med Econ 2004;7:41–51.
    1. Joyce AT, Iacoviello JM, Nag S, Sajjan S, Jilinskaia E, Throop D, et al. End-stage renal disease associated managed care costs among patients with and without diabetes. Diabetes Care. 2004; 27(12):2829–2835. - PubMed
    1. Herman WH, Shahinfar S, Carides GW, Dasbach EJ, Gerth WC, Alexander CM, et al. Losartan reduces the costs associated with diabetic end-stage renal disease: the RENAAL study economic evaluation. Diabetes Care. 2003;26(3):683–687. - PubMed
    1. The Henry J. Kaiser Family Foundation. Health insurance coverage in America: 2002 data update. The Henry J. Kaiser Family Foundation, Kaiser Commission on Medicaid and the Uninsured; Washington (DC): 2003. Available from: URL:

Publication types

MeSH terms