title: Estimating the cost of type 1 diabetes in the U.S.: a propensity score matching method.
abstract: BACKGROUND
  Diabetes costs represent a large burden to both patients and the health care system. However, few studies that examine the economic consequences of diabetes have distinguished between the two major forms, type 1 and type 2 diabetes, despite differences in underlying pathologies. Combining the two diseases implies that there is no difference between the costs of type 1 and type 2 diabetes to a patient. In this study, we examine the costs of type 1 diabetes, which is often overlooked due to the larger population of type 2 patients, and compare them to the estimated costs of diabetes reported in the literature.
  
  
  RESULTS
  Using a nationally representative dataset, we estimate yearly and lifetime medical and indirect costs of type 1 diabetes by implementing a matching method to compare a patient with type 1 diabetes to a similar individual without the disease. We find that each year type 1 diabetes costs this country $14.4 billion (11.5-17.3) in medical costs and lost income. In terms of lost income, type 1 patients incur a disproportionate share of type 1 and type 2 costs. Further, if the disease were eliminated by therapeutic intervention, an estimated $10.6 billion (7.2-14.0) incurred by a new cohort and $422.9 billion (327.2-519.4) incurred by the existing number of type 1 diabetic patients over their lifetime would be avoided.
  
  
  CONCLUSIONS
  We find that the costs attributed to type 1 diabetes are disproportionately higher than the number of type 1 patients compared with type 2 patients, suggesting that combining the two diseases when estimating costs is not appropriate. This study and another recent contribution provides a necessary first step in estimating the substantial costs of type 1 diabetes on the U.S.
authors.affiliation: Center for Health Research and Policy, CNA, Alexandria, Virginia, United States of America. betatao@gmail.com
authors.forename: Betty
authors.initials: B
authors.lastname: Tao
authors.forename: Massimo
authors.initials: M
authors.lastname: Pietropaolo
authors.forename: Mark
authors.initials: M
authors.lastname: Atkinson
authors.forename: Desmond
authors.initials: D
authors.lastname: Schatz
authors.forename: David
authors.initials: D
authors.lastname: Taylor
mesh_terms: D003922:Diabetes Mellitus, Type 1 / Q000191:economics; D005260:Female; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D014481:United States