How diabetes could drain $5 trillion from the global economy by 2050

by · News-Medical

New modeling shows diabetes is not only a health crisis but also a long-term economic threat, with disability, treatment costs, and lost productivity projected to reshape global output for decades.

Study: The global economic burden of diabetes for 190 countries 2021-50: a macroeconomic modelling study. Image Credit: megaflopp / Shutterstock

Modeling results indicated a potential reduction of more than five trillion international dollars in economic output across 190 countries and territories between 2021 and 2050. Researchers observed country-level variations; however, a consistent global pattern emerged: diabetes-related disability and morbidity accounted for the majority of economic losses. The findings underscore the need to improve diabetes management to improve quality of life and reduce pressure on healthcare systems.

Global Diabetes Economic Burden Background

Diabetes prevalence continues to rise globally due to nutritional insecurity, physical inactivity, air pollution, population aging, and related lifestyle and environmental risk factors. The clinical consequences of diabetes are well-established. These include cardiovascular disease, kidney disease, blindness, limb loss, disability, and early death. The long-term economic impact, however, remains unclear. Previous studies focused on diabetes-related medical expenses in individual countries, leaving gaps in overall economic evaluations of the condition across the globe. Improved understanding of the potential economic burden could inform policymaking and help guide prevention programs, tailored by country and region to improve overall health.

Macroeconomic Diabetes Modeling Study Design

In the present study, researchers estimated the long-term economic consequences of diabetes across 190 countries and territories between 2021 and 2050. The study included two scenarios: a status quo and a counterfactual. The status quo scenario represented current diabetes trends without additional interventions. The counterfactual scenario assumed that diabetes could be eliminated completely at no additional cost. The cumulative difference in the projected gross domestic product (GDP) between the two scenarios over the study period indicated the macroeconomic burden.

The model included estimates of effective labor supply and physical capital accumulation. These estimates enabled researchers to account for changes in the workforce, productivity, treatment expenditures, savings, and demographic patterns. Unlike conventional cost-of-illness methods, the model accounted for productivity differences by sociodemographic characteristics, including education and work experience. The team projected human capital using age-specific labor supply data and exponential modeling, accounting for levels of education and work experience.

The Global Burden of Disease 2021 (GBD 2021) database provided data on diabetes incidence, prevalence, disability-adjusted life years, years of life lost, and mortality. The researchers obtained demographic, economic, education, labor, and capital data from several international databases. These included data from the International Labor Organization (ILO), the Penn World Table (PWT), the World Bank, and the United Nations.

The team converted all estimates to 2017 international dollars for cross-country comparisons. They also modeled intermediate scenarios that considered reductions of 10% and 20% in diabetes burden by 2050. Sensitivity analyses included different discount rates and uncertainty intervals for morbidity and mortality estimates.

Diabetes Productivity Loss and Regional Results

Modeling efforts indicated that diabetes could reduce cumulative global economic output by 5.177 trillion international dollars between 2021 and 2050. This value represents about 0.12% of the projected global GDP. The estimated per-capita cost was 591 dollars. Diabetes-related disability accounted for most economic losses. The findings highlight that diabetes-related morbidity could reduce productivity and affect daily functioning for patients worldwide.

The economic impact varied considerably across countries and regions. In absolute terms, the United States (US) accounted for the largest overall losses. China and India were expected to have the next biggest losses. Relative to GDP, Kuwait, the US, and South Korea experienced the highest losses. People in Guyana, the US, and Singapore were estimated to bear the biggest per-capita economic losses.

The disease burden was not distributed equally across regions. North America had the highest projected macroeconomic burden from diabetes. It also had one of the highest per-person costs, despite representing only seven percent of the world’s disability-adjusted life years (DALYs) related to diabetes. South Asia had a much larger share of the global burden from diabetes, contributing nearly one-quarter of global DALYs, but showed smaller economic losses in dollar terms.

The projected economic burden was largest in high-income countries. They could lose approximately 3.217 trillion international dollars in economic output, with per-person costs exceeding 2,500 dollars. However, low- and middle-income countries carried a disproportionately high disease burden, accounting for 81% of global DALYs. But, due to smaller economies, lower average incomes, lower treatment intensity, and different healthcare cost structures, the financial losses appeared lower in dollar terms. Lowering the diabetes-related burden by 20% by 2050 could yield worldwide gains of about $ 190 billion. Reducing diabetes-related incidence and mortality to the lowest observed global levels could yield an estimated 1.11 trillion dollars in global macroeconomic gains.

Diabetes Burden Modeling Limitations

The authors noted several limitations. The model did not account for changes in workforce participation among household members caring for people with diabetes, potentially underestimating the burden. Missing data for 64 countries and territories were interpolated or projected, treatment costs were extrapolated partly from US and other high-income country data, and estimates inherited uncertainty from GBD inputs. These assumptions mean country-level point estimates should be interpreted cautiously.

Diabetes Prevention and Economic Policy Implications

The study findings suggest that diabetes may not only harm patients but also affect societies and economies through healthcare costs, disability, lower productivity, and early deaths. The estimated global economic loss from diabetes may even exceed Japan’s 2021 GDP. The authors argue that governments should increase investments in diabetes prevention and treatment, improve access to healthcare services, and make treatments more affordable to strengthen the global economy, not just improve health for patients worldwide.

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