Economics in pediatric type 1 diabetes - results from recently published studies.
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.
Icks
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Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Institute at Heinrich Heine University Düsseldorf, Germany. icks@ddz.uni-duesseldorf.de
Holl
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Giani
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D002648:Child; D017281:Cost of Illness; D003922:Diabetes Mellitus, Type 1 / Q000191:economics*; D005069:Evaluation Studies as Topic; D017048:Health Care Costs; D006801:Humans