title: Direct medical cost and glycemic control in type 2 diabetic Saudi patients.
abstract: BACKGROUND
  The prevalence of diabetes mellitus continues to increase globally. Furthermore, it is projected that healthcare expenditure on this epidemic will mount to US$490 billion in 2030. Information on the economic burden of diabetes care in Saudi Arabia is largely lacking.
  
  
  OBJECTIVE
  This retrospective observational study evaluated the direct medical cost of type 2 diabetes mellitus (T2DM) in a Saudi population in relation to glycemic control at a governmental institution from a payer's perspective.
  
  
  METHODS
  Three hundred subjects attending a university hospital were classified into three groups (n = 100 each) based on HbA1c values to <7 %, 7-9 %, and >9 %. The total direct medical costs were calculated for drug therapy, diagnostic procedures, hospitalization, and outpatient visits. The year of valuation for the costings was 2010/2011.
  
  
  RESULTS
  The total annual direct medical cost per group was found to be US$1,384.19 for HbA1c <7 %, US$2,036.11 for HbA1c 7-9 %, and US$3,104.86 for HbA1c >9 % (p < 0.001). There was also a statistically positive relationship in the total care cost of diabetic patients and the number of co-morbidities (p < 0.001). A direct association of the cost of medications that have been disbursed for diabetic patients and the medical specialty of the treating physician (r = 0.390; p < 0.0001), and the cost of laboratory analyses (r = 0.351; p < 0.0001), was observed as also between the cost of laboratory diagnosis and days of hospitalization (r = 0.478; p < 0.0001). Multivariate analysis showed that the relationship between HbA1c and total cost is independent of age and gender, while co-morbidities remain as a significant predictor for the total cost.
  
  
  CONCLUSIONS
  Collectively, the estimated direct annual medical cost of diabetes care in Saudi Arabia would be enormous. The current study offers more insight into the economic burden of diabetes on the country.
authors.affiliation: Department of Pharmacy, King Saud Medical Complex, Riyadh, Saudi Arabia.
authors.forename: Nora
authors.initials: N
authors.lastname: Almutairi
authors.forename: Khalid M
authors.initials: KM
authors.lastname: Alkharfy
mesh_terms: D017281:Cost of Illness; D003710:Demography; D003924:Diabetes Mellitus, Type 2 / Q000191:economics* / Q000628:therapy*; D005260:Female; D017048:Health Care Costs; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012529:Saudi Arabia