title: Cost of diabetic eye, renal and foot complications: a methodological review.
abstract: BACKGROUND
  Diabetic retinopathy (DR), diabetic kidney disease (DKD) and diabetic foot ulcer (DFU) represent a public health and economic concern that may be assessed with cost-of-illness (COI) studies.
  
  
  OBJECTIVE
  (1) To review COI studies published between 2000 and 2015, about DR, DKD and DFU; (2) to analyse methods used.
  
  
  METHODS
  Disease definition, epidemiological approach, perspective, type of costs, activity data sources, cost valuation, sensitivity analysis, cost discounting and presentation of costs may be described in COI studies. Each reviewed study was assessed with a methodological grid including these nine items.
  
  
  RESULTS
  The five following items have been detailed in the reviewed studies: epidemiological approach (59 % of studies described it), perspective (75 %), type of costs (98 %), activity data sources (91 %) and cost valuation (59 %). The disease definition and the presentation of results were detailed in fewer studies (respectively 50 and 46 %). In contrast, sensitivity analysis was only performed in 14 % of studies and cost discounting in 7 %. Considering the studies showing an average cost per patient and per year with a societal perspective, DR cost estimates were US $2297 (range 5-67,486), DKD cost ranged from US $1095 to US $16,384, and DFU cost was US $10,604 (range 1444-85,718).
  
  
  CONCLUSIONS
  This review reinforces the need to adequately describe the method to facilitate literature comparisons and projections. It also recalls that COI studies represent complementary tools to cost-effectiveness studies to help decision makers in the allocation of economic resources for the management of DR, DKD and DFU.
authors.affiliation: Unité Inserm 1027, Faculté de Médecine, National Institute for Health and Medical Research (Inserm), Research Unit 1027, 37 allées Jules Guesde, 31073, Toulouse, France. schirr-bonnans.s@chu-toulouse.fr.|University of Science of Toulouse III, Université Paul Sabatier Toulouse III, Bâtiment 1R1, 31062, Toulouse Cedex 9, France. schirr-bonnans.s@chu-toulouse.fr.|Diabetology Metabolic Disease and Nutrition Department, Service de Diabétologie, Maladies Métaboliques et Nutrition, Hôpital Rangueil, University Hospital of Toulouse, 1 avenue Jean Poulhès, TSA 50032, 31059, Toulouse Cedex 9, France. schirr-bonnans.s@chu-toulouse.fr.
authors.forename: Solène
authors.initials: S
authors.lastname: Schirr-Bonnans
authors.affiliation: Unité Inserm 1027, Faculté de Médecine, National Institute for Health and Medical Research (Inserm), Research Unit 1027, 37 allées Jules Guesde, 31073, Toulouse, France.|Medical Information Department, University Hospital of Toulouse, Hôtel-Dieu Saint-Jacques, 2, rue viguerie, 31059, Toulouse Cedex 9, France.
authors.forename: Nadège
authors.initials: N
authors.lastname: Costa
authors.affiliation: Medical Information Department, University Hospital of Toulouse, Hôtel-Dieu Saint-Jacques, 2, rue viguerie, 31059, Toulouse Cedex 9, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Derumeaux-Burel
authors.affiliation: Medical Information Department, University Hospital of Toulouse, Hôtel-Dieu Saint-Jacques, 2, rue viguerie, 31059, Toulouse Cedex 9, France.
authors.forename: Jérémy
authors.initials: J
authors.lastname: Bos
authors.affiliation: Unité Inserm 1027, Faculté de Médecine, National Institute for Health and Medical Research (Inserm), Research Unit 1027, 37 allées Jules Guesde, 31073, Toulouse, France.|University of Science of Toulouse III, Université Paul Sabatier Toulouse III, Bâtiment 1R1, 31062, Toulouse Cedex 9, France.|Methodological Support Unit, Faculté de Médecine, University Hospital of Toulouse, USMR, 37 allées Jules Guesde, 31073, Toulouse, France.
authors.forename: Benoît
authors.initials: B
authors.lastname: Lepage
authors.affiliation: Medical Information Department, University Hospital of Toulouse, Hôtel-Dieu Saint-Jacques, 2, rue viguerie, 31059, Toulouse Cedex 9, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Garnault
authors.affiliation: Diabetology Metabolic Disease and Nutrition Department, Service de Diabétologie, Maladies Métaboliques et Nutrition, Hôpital Rangueil, University Hospital of Toulouse, 1 avenue Jean Poulhès, TSA 50032, 31059, Toulouse Cedex 9, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Martini
authors.affiliation: University of Science of Toulouse III, Université Paul Sabatier Toulouse III, Bâtiment 1R1, 31062, Toulouse Cedex 9, France.|Diabetology Metabolic Disease and Nutrition Department, Service de Diabétologie, Maladies Métaboliques et Nutrition, Hôpital Rangueil, University Hospital of Toulouse, 1 avenue Jean Poulhès, TSA 50032, 31059, Toulouse Cedex 9, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Hanaire
authors.affiliation: Diabetology Metabolic Disease and Nutrition Department, Service de Diabétologie, Maladies Métaboliques et Nutrition, Hôpital Rangueil, University Hospital of Toulouse, 1 avenue Jean Poulhès, TSA 50032, 31059, Toulouse Cedex 9, France.|Medical Information Department, University Hospital of Toulouse, Hôtel-Dieu Saint-Jacques, 2, rue viguerie, 31059, Toulouse Cedex 9, France.
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Turnin
authors.affiliation: Unité Inserm 1027, Faculté de Médecine, National Institute for Health and Medical Research (Inserm), Research Unit 1027, 37 allées Jules Guesde, 31073, Toulouse, France.|University of Science of Toulouse III, Université Paul Sabatier Toulouse III, Bâtiment 1R1, 31062, Toulouse Cedex 9, France.|Medical Information Department, University Hospital of Toulouse, Hôtel-Dieu Saint-Jacques, 2, rue viguerie, 31059, Toulouse Cedex 9, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Molinier
mesh_terms: D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D048909:Diabetes Complications / Q000191:economics* / Q000453:epidemiology*; D017719:Diabetic Foot / Q000191:economics; D003928:Diabetic Nephropathies / Q000191:economics; D003930:Diabetic Retinopathy / Q000191:economics; D005102:Health Expenditures; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D017059:Models, Econometric; D012107:Research Design; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology
keywords: Chronic complications; Cost-of-illness; Diabetes; Methods; Review