Aims: The purpose of this study was to characterize the financial cost and efficacy of primary care treatment for diabetes in the United Kingdom from 1997 to 2007.
Methods: Retrospective data were analysed for people with Type 1 and Type 2 diabetes along with matched control subjects using data from The Health Improvement Network. Costs were attributed from published sources and adjusted for price inflation. Type 2 diabetes was analysed by five commonly used treatment regimens.
Results: It was possible to identify 126 052 people for inclusion: 11 300 (8.9%) with Type 1 diabetes and 114 752 (91.1%) with Type 2. The overall mean prescribing costs per person per year (pppy) increased markedly for people with diabetes from 1997 to 2007: for Type 1, from 573 pounds to 1014 pounds pppy (+77%), and for Type 2, from 39 pounds to 740 pounds pppy (+89%). In 2007, diabetes-treatment-specific prescribing represented 57% of prescribing costs in Type 1 diabetes and 28% in Type 2 diabetes. In Type 2 diabetes there was a mean of 5.4 primary care consultations in 1997, increasing to 11.5 pppy in 2007 (+112%). In 1997 the total mean cost of primary care treatment for Type 2 diabetes was 602 pounds pppy, increasing to 1080 pounds in 2007. In Type 1 diabetes, the mean glycated haemoglobin decreased by 0.1% from 8.8% in 2001 to 8.7% in 2007; the corresponding change using insulin in Type 2 diabetes was also 0.1%. Greater improvement in blood pressure and lipids was evident.
Conclusions: Over the 10 year period to 2007, diabetes-related primary care adjusted costs increased considerably, whereas glycated haemoglobin values did not improve at all over the same period.