Diabetes has become much more than a medical challenge; it is also an economic challenge, Andrew T.Simkin, U.S. Consul General, said.
The challenge also becomes greater with advances in medicine, leading to extra expenditure on the part of the patients. Allocation of resources to handle the chronic condition and its complications is an issue that needs to be addressed. Drawing parallels to the health policy debate in the United States, he highlighted issues relating to access and affordability of care.
Even the United States is facing a severe and growing challenge from diabetes which currently affects 23.6 million people in that country. It continues to be a lifestyle issue, affecting fundamentally the way people live -- how they eat, whether they exercise, he said.
Mr. Simkin called for a multi-disciplinary approach to Diabetes, speaking at the inaugural of a seminar on the socio-economic impact of Diabetes and its complications organised by M.V.Hospital for Diabetes. Earlier he released a special manual on diabetes and handed over the first copy to T.N.Ravishankar, State Secretary, Indian Medical Association.
Vijay Viswanathan, Managing Director, M.V.Hospital for Diabetes, said among developing countries, the greatest increase will be seen in India, where the number of people with diabetes would have risen from 19 million in 1995 to 57 million in 2025, according to WHO/International Diabetes Foundation projections.
Diabetes is an expensive medical condition, being chronic and affecting nearly every major organ and blood vessels in the body, he added. This is evidenced by the cost of spending on diabetes in most countries of the world: Australia and China spend US $ 3.5 billion, while Japan spends US $ 16.9 billion.
The annual direct cost for routine diabetes care in India was US $ 191 and cost per hospitalisation was US $ 208 in 1998. Other Indian studies have reported that diabetic subjects on an average spent anywhere between US $ 107 to US $ 253. The presence of other co-morbid conditions, such as hypertension, and complications of diabetes including retinopathy, neuropathy and nephropathy, increase the costs further, he added. Apart from the direct costs themselves, there are indirect costs resulting from loss of days of work, employment, and travel expenses.
A recent study showed that over 70 per cent of Indians are using savings lined up for a child’s education or marriage to treat diabetes and its related complications. It also indicated that only 7 per cent had some form of reimbursement- at work or through insurance. In India, there are sufficient studies to show that out of pocket expenditure is high.
Dr.Viswanathan added that the intention of the workshop was to form a framework of strategies to combat the economic burden of diabetes in India.
S.N.Narasingan, Dean, Diabetes Research Centre, said India cannot tolerate the double burden of diabetes and cardio-vascular disease. From the cost aspect, he said economics of care was hardly stressed on in medical college, asking for a change in the situation.