Direct medical costs of type 2 diabetes mellitus in the Philippines: findings from two hospital databases and physician surveys

OBJECTIVE: To estimate the annual direct medical cost of type 2 diabetes mellitus (T2DM) in hospitals and outpatient care clinics from a healthcare payer perspective in the Philippines. DESIGN AND PARTICIPANTS: (1) A review of electronic hospital records of people with T2DM in two tertiary hospitals—Ospital ng Makati (OsMak) and National Kidney and Transplant Institute (NKTI) and (2) a cross-sectional survey with 50 physicians providing outpatient care for people with T2DM. SETTING: Primary, secondary and tertiary healthcare facilities in Metro Manila. OUTCOME MEASURES: Cost of managing T2DM and its related complications in US dollars (USD) in 2016. RESULTS: A total of 1023 and 1378 people were identified in OsMak and NKTI, with a complication rate of 66% and 74%, respectively. In both institutions, the average annual cost per person was higher if individuals were diagnosed with any complication (NKTI: US$3226 vs US$2242 and OsMak: US$621 vs US$127). Poor diabetes control was estimated to incur higher per person cost than good control in both public outpatient care (poor control, range: US$727 to US$2463 vs good control, range: US$614 to US$1520) and private outpatient care (poor control, range: US$848 to US$2507 vs good control, range: US$807 to US$1603). CONCLUSION: The results highlight the high direct medical cost resulting from poor diabetes control and the opportunity for cost reduction by improving control and preventing its complications.