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Economics in pediatric type 1 diabetes - results from recently published studies
1Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Institute at Heinrich Heine University Düsseldorf, Germany. icks@ddz.uni-duesseldorf.de
Insights
Health economic studies on pediatric diabetes are limited. Hospitalization is a major cost driver, but home intervention models may be cost-effective for managing childhood type 1 diabetes.
Area of Science:
- Pediatric Endocrinology
- Health Economics
- Public Health
Background:
- Childhood type 1 diabetes (T1D) incidence is rising globally.
- Pediatric diabetes care models and therapies are evolving.
- Understanding the economic impact is crucial for strategic clinical decisions, yet knowledge is limited.
Purpose of the Study:
- To systematically review and describe recent economic analyses of pediatric diabetes care.
- To identify cost drivers and evaluate the economic effectiveness of different care strategies.
- To highlight gaps in current health economic research for childhood T1D.
Main Methods:
- Systematic literature search for published economic analyses on pediatric diabetes.
- Inclusion of cost-of-illness studies and intervention evaluations.
- Analysis of study perspectives, cost components, and comparative effectiveness.
Main Results:
- Ten economic analyses were identified, with four focusing on cost of illness.
- Hospitalization emerged as a significant cost component, driven by metabolic control, education, and acute complications.
- Home and ambulatory care interventions showed potential cost-effectiveness compared to routine care, though evidence is limited.
Conclusions:
- Health economic research in pediatric diabetes is sparse and variable in quality.
- Hospitalization significantly impacts healthcare costs for children and adolescents with diabetes.
- Further research is needed to assess the clinical and cost-effectiveness of pediatric diabetes care models, particularly home-based interventions.
Objective:
Type 1 diabetes in childhood is increasing worldwide. Several therapy components and models of pediatric diabetes care have been introduced. Economic aspects are of increasing interest to decide appropriate strategies in clinical practice. However, knowledge in pediatric diabetes is limited.
Methods:
We conducted a literature research to identify and describe systematically recently published analyses on the economics of pediatric diabetes.
Results:
We substracted ten analyses. Four were cost of illness studies. The main result is that hospitalization, mainly due to metabolic control, education, and acute complications, seems to be a large cost component. Only one study took the perspective of society, including indirect costs. Four of the six studies which evaluated interventions in pediatric diabetes care focussed on ambulatory or home care strategies. Detailed evaluation of new technologies, pharmacotherapy, or screening for late complications is lacking. Except one, all studies performed cost comparison analyses. Evidence is limited, however, diabetes care models may be effective and, possibly, cost saving compared to routine care.
Conclusions:
Health economic studies in pediatric diabetes are scarse and limited with respect to topics and quality. Hospitalization has a large impact on health care costs in diabetic children and adolescents. Models in pediatric diabetes care like home intervention may be cost effective compared to more traditional strategies of care. However, further studies are warranted which evaluate clinical and cost effectiveness in pediatric diabetes.
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