Diabetes costing health system more than $9 billion

With one in 20 adults living with diabetes, the chronic condition has become one of the most common presentations in general practice, accounting for more than 10% of patient encounters.
 
With numbers projected to grow, there is growing concern about the substantial burden diabetes is placing on the healthcare system, and now updated estimates have revealed the cost could be up to three times more than previously thought.
 
According to a new analysis by Diabetes Australia, the chronic condition is costing the health system $9.1 billion each year – a considerable jump from the $3.4 billion previously estimated by the Australian Institute of Health and Welfare in 2020–21.
 
Diabetes Australia’s Group CEO Justine Cain said the latest figures should send a clear warning to governments and healthcare providers that diabetes is a public health emergency requiring swift action.
 
‘The cost of diabetes to individuals and our nation is staggering,’ she said.
 
‘Without urgent action to reverse the current trend, our health system will be overwhelmed.
 
‘We need a raft of initiatives to help prevent type 2 diabetes where we can and prevent the costly complications of all types of diabetes in people who are already living with the condition. By doing that, we can help ease the pressure on the whole health system.’
 
According to the peak body, the latest estimates were reached using ‘alternate methods, data sources and analytical approaches’. It takes into account national and international evidence of the health costs of diabetes, as well as the current prevalence across the Australian population.
 
Dr Gary Deed, Chair of RACGP Specific Interests Diabetes, said the revaluation of the true cost of diabetes while surprising, and somewhat alarming, is ‘not unexpected’.
 
‘The costs, of course, are compounded by specialist care costs, but especially hospital care – noting that people are living longer – let alone community costs and burdens such as loss of quality of life and work,’ he told newsGP.
 
Dr Deed said GPs are confronted by the reality of these statistics in their clinical practice daily.
 
‘We are seeing increasing and ongoing numbers diagnosed with type 2 diabetes, and observing higher numbers in younger people,’ he said.
 
‘Plus, we see the need to have supportive systems and clinical resources in place to help support people living with diabetes, including monitoring, assessment for related multi-morbidities, preventing complications, as well as support for therapies and constant revision of care.’
 
On the back of the updated estimates, Diabetes Australia is calling on the Federal Government to invest in public education campaigns and initiatives to help reduce the cost of diabetes, with Ms Cain noting that ‘investing in prevention is an investment in Australia’s future’.
 
Dr Deed agrees, and says it is concerning that Australia has no effective national prevention strategy in place for the condition.
 
He says any investment should extend to primary care, where he says GPs are well placed to both screen for diabetes risk and help with preventative strategies.
 
‘We know that there are modifiable risk factors that trigger a “slide” into type 2 diabetes, including lifestyle factors and having certain pre-existing conditions,’ Dr Deed said.
 
‘GPs are well suited to provide targeted screening of high-risk individuals and incentives need to be given to allow this to be a focus of high-quality primary care.
 
‘Plus, GPs need to be supported to provide the care required for the spectrum of presentations from early diagnosis and the push for remission of type 2 diabetes to multimorbidity management, which requires co-ordinated and team-based care.’
 
According to Dr Deed, an incentive worth considering for people with complex diabetes is additional funding to allow for more than five allied health team-based chronic condition management items. 
 
‘These people need greater team-based support, and it would be an economic, health and personal advantage to be able to fund more than five,’ he said.
 
Meanwhile, to help raise awareness about diabetes, Ms Cain has proposed Australia run a campaign similar to those for melanoma and breast cancer. She says, as it stands, Australia is ‘lagging behind’ other OECD nations in how we combat diabetes.
 
‘We know that education and public health initiatives promoting healthy diets and active lifestyles can make a significant difference,’ she said.
 
‘Genetics plays a key role in the development of type 2 diabetes, but we also know that up to 58% of diagnoses can be prevented or delayed through lifestyle changes.
 
‘We need to increase public awareness about that so people know their risk factors and can take positive steps for their health.’
 
Dr Deed agrees that public health initiatives are useful, so long as those identified as high-risk can be supported and educated, and that adequate service support is available.
 
‘Currently, Medicare does not provide an adequate platform for managing risk factors in any co-ordinated way for diabetes,’ he said.
 
‘Identifying risks and then translating this into effective action requires a whole of health co-ordinated approach. But there are supportive programmes that exist across the states that may be utilised if such a campaign was commenced.’
 
Currently, one person in Australia is diagnosed with diabetes every five minutes. If this continues, it is projected that up to 3.6 million people will be living with diabetes by 2050.
 
But Dr Deed says there is hope if action is taken now.
 
‘Identify high risk people and support primary care to provide early intervention,’ he said.
 
‘Fund the work done by our GPs without burdening them with extra administrative burdens.
 
‘I believe people want to be healthy and they want our health system to provide that for them, not just focus on or wait for emergent disease, especially if it is preventable.’
 
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