The health care costs of diabetic peripheral neuropathy in the US.
OBJECTIVE
Peripheral neuropathy is common among people with diabetes and can result in foot ulceration and amputation. The aim of this study was to quantify the annual medical costs of peripheral neuropathy and its complications among people with type 1 and type 2 diabetes in the U.S.


METHODS
A cost-of-illness model was used to estimate the numbers of diabetic individuals in the U.S. who have diabetic peripheral neuropathy (DPN) and/or neuropathic foot ulcers (both those with no deep infection and those accompanied by cellulitis or osteomyelitis) at a given point in time, and/or a toe, foot, or leg amputation during a year. Prevalence and incidence rates were estimated from published studies and applied to the general U.S. population. All costs were estimated in 2001 U.S. dollars. In a sensitivity analysis, we varied the rates of complications to assess the robustness of the cost estimates.


RESULTS
The annual costs of DPN and its complications in the U.S. were 0.8 billion US dollars (type 1 diabetes), 10.1 billion US dollars (type 2 diabetes), and 10.9 billion US dollars (total). After allowing for uncertainty in the point estimates of complication rates, the range of costs were between 0.3 and 1.0 billion US dollars (type 1 diabetes), 4.3b and 12.7 billion US dollars (type 2 diabetes), and 4.6 and 13.7 billion US dollars (type 1 and type 2 diabetes).


CONCLUSIONS
The total annual cost of DPN and its complications in the U.S. was estimated to be between 4.6 and 13.7 billion US dollars. Up to 27% of the direct medical cost of diabetes may be attributed to DPN.
Gordois
Adam
A
York Health Economics Consortium, University of York, Heslington, York, UK.
Scuffham
Paul
P
Shearer
Arran
A
Oglesby
Alan
A
Tobian
Janet Ash
JA
D000671:Amputation, Surgical / Q000191:economics; D002481:Cellulitis / Q000191:economics / Q000453:epidemiology; D003365:Costs and Cost Analysis; D003920:Diabetes Mellitus / Q000453:epidemiology; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D017719:Diabetic Foot / Q000191:economics / Q000601:surgery; D003929:Diabetic Neuropathies / Q000191:economics* / Q000453:epidemiology; D005528:Foot / Q000601:surgery; D006801:Humans; D007866:Leg / Q000601:surgery; D015233:Models, Statistical; D010019:Osteomyelitis / Q000150:complications / Q000191:economics; D015995:Prevalence; D014034:Toes / Q000601:surgery; D014481:United States / Q000453:epidemiology