Social economic costs of type 1 diabetes mellitus in pediatric patients in Spain: CHRYSTAL observational study.
OBJECTIVE
To estimate the social-economic costs of Type 1 Diabetes Mellitus (T1DM) in patients aged 0-17years in Spain from a social perspective.


METHODS
We conducted a cross-sectional observational study in 2014 of 275 T1DM pediatric outpatients distributed across 12 public health centers in Spain. Data on demographic and clinical characteristics, healthcare utilization and informal care were collected from medical records and questionnaires completed by clinicians and patients' caregivers.


RESULTS
A valid sample of 249 individuals was analyzed. The average annual cost for a T1DM patient was €27,274. Direct healthcare costs were €4070 and direct non-healthcare cost were €23,204. Informal (familial) care represented 83% of total cost, followed by medical material (8%), outpatient and primary care visits (3.1%) and insulin (2.1%). Direct healthcare cost per patient statistically differed by glycated haemoglobin (HbA1c) level [mean cost €4704 in HbA1c ≥7.5% (≥58mmol/mol) group vs. €3616 in HbA1c<7.5% (<58mmol/mol) group)]; and by the presence or absence of complications and comorbidities (mean cost €5713 in group with complications or comorbidities vs. €3636 in group without complications or comorbidities).


CONCLUSIONS
T1DM amongst pediatric patients incurs in considerable societal costs. Informal care represents the largest cost category.
University of Castilla-La Mancha, Avda. Real Fábrica de Seda, s/n, 45600 Talavera de la Reina, Toledo, Spain. Electronic address: julio.lopezbastida@uclm.es.
Julio
J
López-Bastida
Pediatric Endocrinology Department, Regional University Hospital, Avda Arroyo de los Ángeles s/n, 29011 Málaga, Spain.
Juan Pedro
JP
López-Siguero
Department of Economics and Finance, University of Castilla-La Mancha, Cobertizo de San Pedro Mártir s/n, 45071 Toledo, Spain.
Juan
J
Oliva-Moreno
Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN 46285, USA.
Magaly
M
Perez-Nieves
Instituto Max Weber, Calle Norias 123, 28221 Majadahonda (Madrid), Spain.
Renata
R
Villoro
Eli Lilly and Company, Avda. de la Industria 30, 28108 Alcobendas (Madrid), Spain.
Tatiana
T
Dilla
Instituto Max Weber, Calle Norias 123, 28221 Majadahonda (Madrid), Spain.
María
M
Merino
Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN 46285, USA.
Dingfeng
D
Jiang
Department of Economics and Finance, University of Castilla-La Mancha, Avda. Real Fábrica de Seda, s/n, 45600 Talavera de la Reina, Toledo, Spain.
Isaac
I
Aranda-Reneo
Eli Lilly and Company, Avda. de la Industria 30, 28108 Alcobendas (Madrid), Spain.
Jesús
J
Reviriego
Department of Endocrinology, Marqués de Valdecilla University Hospital, Avda Valdecilla, 39008 Santander, Spain.
Luis Alberto
LA
Vázquez
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000191:economics*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012959:Socioeconomic Factors; D013030:Spain; D011795:Surveys and Questionnaires
Costs studies; Pediatric population; Social costs; Type 1 diabetes mellitus