OBJECTIVES: Patients with type 2 diabetes mellitus (T2DM) are at greater risk of experiencing a stroke or myocardial infarction (MI) than those without T2DM. A systematic literature review summarized published cost estimates of stroke and MI to better understand the economic burden for T2DM patients experiencing these comorbidities.
METHODS: Electronic databases (2001-2011) and conference abstracts (2011-2012) were searched for publications on costs, utilities, and quality of life in the English language. This review reports the cost estimates identified. Costs were converted to year 2011 pounds sterling using purchasing power parity data and inflation indices.
RESULTS: Fifty-one studies (11 primary cost studies; 40 economic evaluations) were identified presenting costs associated with an MI and/or stroke in patients with T2DM. All studies were performed in adults. No studies accounted for event severity. Nine primary cost studies reported per-patient direct costs for the year of a nonfatal event. Cost estimates ranged from £5,034 to £29,034 for MI and from £1,721 to £38,448 for stroke. For subsequent years, cost studies reported either annual or total followup costs. Annual costs for stroke ranged from £639 to £12,831; for MI, 1 study reported a cost of £1,605. Total follow-up costs ranged from £284 to £8,988 for stroke and from £284 to £1,123 for MI. Only 1 study estimated direct costs for fatal events: £2,463 for MI and £6,645 for stroke. None of the 11 primary cost studies reported indirect costs associated with MI or stroke. However, 1 of the 40 economic evaluations identified reported indirect costs for the event year and subsequent years.
CONCLUSIONS: Literature on costs for MI and stroke specific to T2DM patients is sparse, with extensive variability between estimates identified. Further studies are needed to provide reliable cost estimates by severity of stroke and MI events in T2DM patients of all ages.
