title: The cost of diabetes in Canada over 10 years: applying attributable health care costs to a diabetes incidence prediction model.
abstract: BACKGROUND
  Our objective was to estimate the future direct health care costs due to diabetes for a 10-year period in Canada using national survey data, a validated diabetes risk prediction tool and individual-level attributable cost estimates.
  
  
  METHODS
  We used the Diabetes Population Risk Tool to predict the number of new diabetes cases in those aged 20 years and above over a 10-year period (to 2022), using 2011 and 2012 Canadian Community Health Survey data. We derived attributable costs due to diabetes from a propensity-matched case control study using the Ontario Diabetes Database and other administrative data. We calculated total costs by applying the respective attributable costs to the incident cases, accounting for sex, year of diagnosis and annual disease-specific mortality rates.
  
  
  RESULTS
  The predicted 10-year risk of developing diabetes for the Canadian population in 2011/12 was 9.98%, corresponding to 2.16 million new cases. Total health care costs attributable to diabetes during this period were $7.55 billion for females and $7.81 billion for males ($15.36 billion total). Acute hospitalizations accounted for the greatest proportion of costs (43.2%). A population intervention resulting in 5% body weight loss would save $2.03 billion in health care costs. A 30% risk-reduction intervention aimed at individuals with the highest diabetes risk (i.e. the top 10% of the highest-risk group) would save $1.48 billion.
  
  
  CONCLUSIONS
  Diabetes represents a heavy health care cost burden in Canada through to the year 2022. Our future cost calculation method can provide decision makers and planners with an accessible and transparent tool to predict future expenditures attributable to the disease and the corresponding cost savings associated with interventions.
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Anja
authors.initials: A
authors.lastname: Bilandzic
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.|Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.|Public Health Ontario, Toronto, Ontario, Canada.
authors.forename: Laura
authors.initials: L
authors.lastname: Rosella
mesh_terms: D001835:Body Weight; D002170:Canada / Q000453:epidemiology; D017046:Cost Savings; D003920:Diabetes Mellitus / Q000191:economics* / Q000453:epidemiology*; D005260:Female; D005544:Forecasting; D015438:Health Behavior; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006293:Health Promotion / Q000191:economics*; D006760:Hospitalization / Q000191:economics; D006801:Humans; D015994:Incidence; D008297:Male; D040242:Risk Reduction Behavior; D061217:Weight Reduction Programs / Q000191:economics
keywords: Canada; attributable cost; diabetes; economics; incidence; prediction model