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Double the chronic disease equals more than double the cost

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Having more than one chronic disease amplifies the cost of treatment over and above that expected from treating the diseases separately, New Zealand-led research has found. The study looked at six non-communicable disease groups, including cancer, heart disease and diabetes. Nearly of a quarter of spending on treating these diseases went to people who had two or more of these chronic illnesses, suggesting the need for better policy and planning in the face of an ageing population that commonly has multiple illnesses.

Journal/conference: PLOS Medicine

Link to research (DOI): 10.1371/journal.pmed.1002716

Organisation/s: University of Otago, The University of Melbourne

Funder: The Burden of Disease Epidemiology, Equity & Cost-Effectiveness Programme (BODE3), which supported this research, is funded by the Health Research Council of New Zealand. Funding support was also provided by the National Health and Medical Research Council and the Australian Research Council. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of this manuscript.

Media Release

From: PLOS

Having more than one chronic disease amplifies costs of diseases, study finds

Having two or more non-communicable diseases (multimorbidity) costs the country more than the sum of those individual diseases would cost, according to a new study published this week in PLOS Medicine by Tony Blakely from the University of Otago, New Zealand, and colleagues.

Few studies have estimated disease-specific health system expenditure for many diseases simultaneously. In the new work, the researchers used nationally linked health data for all New Zealanders, including hospitalization, outpatient, pharmaceutical, laboratory and primary care from July 1, 2007 through June 30, 2014. These data include 18.9 million person-years and $26.4 billion US in spending. The team calculated annual health expenditure per person and analyzed the association of this spending to whether a person had any of six non-communicable disease classes—cancer, cardiovascular disease, diabetes, musculoskeletal, neurological, and lung/liver/kidney (LLK) diseases—or a combination of any of those diseases.

59% of publically-funded health expenditures in New Zealand were attributable to non-communicable diseases. Nearly a quarter (23.8%) of this spending was attributable to the costs of having two or more diseases above and beyond what the diseases cost separately. Of the remaining spending, heart disease and stroke accounted for 18.7%, followed by musculoskeletal (16.2%), neurological (14.4%), cancer (14.1%), LLK disease (7.4%) and diabetes (5.5%).  Expenditure was generally the highest in the year of diagnosis and the year of death.

“There is a surprising lack of disease-attributed costing studies involving multiple diseases at once,” the authors say. “Governments and health systems managers and funders can improve planning and prioritisation knowing where the money goes.”

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