Hospital costs associated with adverse events in people with diabetes in the UK

Aim To estimate the annual hospital costs associated with a range of adverse events for people with diabetes in the UK. Methods Annual hospital costs (2019/2020) were derived from 15 436 ASCEND participants from 2005 to 2017 (120 420 person-years). The annual hospital costs associated with cardiovascular events (myocardial infarction, coronary revascularization, transient ischaemic attack [TIA], ischaemic stroke, heart failure), bleeding (gastrointestinal [GI] bleed, intracranial haemorrhage, other major bleed), cancer (GI tract cancer, non-GI tract cancer), end-stage renal disease (ESRD), lower limb amputation and death (vascular, non-vascular) were estimated using a generalized linear model following adjustment for participants' sociodemographic and clinical factors. Results In the year of event, ESRD was associated with the largest increase in annual hospital cost (20 pound 954), followed by lower limb amputation (17 pound 887), intracranial haemorrhage (12 pound 080), GI tract cancer (10 pound 160), coronary revascularization (8531 pound if urgent; 8302 pound if non-urgent), heart failure (8319) pound, non-GI tract cancer (7409) pound, ischaemic stroke (7170) pound, GI bleed (5557) pound, myocardial infarction (4913) pound, other major bleed (3825) pound and TIA (1523) pound. In subsequent years, most adverse events were associated with lasting but smaller increases in hospital costs, except for ESRD, where the additional cost remained high (20 pound 090). Conclusions Our study provides robust estimates of annual hospital costs associated with a range of adverse events in people with diabetes that can inform future cost-effectiveness analyses of diabetes interventions. It also highlights the potential cost savings that could be derived from prevention of these costly complications.