Diabetes Care in The Netherlands: - Novo Nordisk

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Diabetes Type 1 may be more prevalent than assumed – but databut sources data are sources highly are conflicting highly conflictingNumber of Diabetes Type I Patients based ondifferent sources2010, ‘000CommentsCommentsDVN / DFN1501)• DVN and NDF quote 150,000 Type 1 patients (methodology not further explained)• This translates into 20% of diagnosed diabetes patientsCBSBased on samplein BrabantRIVM98153163• Survey sample in which patients responding yes to 3 questions were identified as Type1: (1) Do you have diabetes? (2) Do you use insulin for this? (3) Did you start usinginsulin within 6 months after being diagnosed?• Drawback of methodology is that the answers to the questions may not be a reliableproxy for share of Type 1 patients• PoZoB (GP support Brabant) includes 15,500 Diabetes Type 2 patients in theirprograms, of which 14% uses insulin• Extrapolating this to the national level, and with a total of 285,000 insulin users(source SFK), this would imply 162.500 Type 1 patients• RIVM estimates 10% Type 1 of diagnosed patients, based on GP registration• Drawback of methodology is that maybe not all Type 1 patients are registered by GP,such that GP registrations are not fully accurateInternationalDiabetes Federation98• IDF estimates 10% Type 1 of diagnosed patients, however not NL specificCMR -Nijmegen96Range• CMR -Nijmegen estimates 9.8% Type 1 (‘05-’08 period) of diagnosed patients, based onGP registration in Nijmegen• Drawback of methodology is that representatively may be questionableEstimate100125• Booz estimates 100,000 to 150,000 Type 1 patients, based on different sources• For calculation purposes the average of 125,000 will be used1) 2011 estimateSource: DVN/DFN, CBS, RIVM, IDF, CMR-Nijmegen, Booz & Company analysisBooz & Company 14 November 2011 Prepared for Novo Nordisk1320
Costs of of complications and treatment of of diabetes diabetes double double of ofreported, lost productivity more than medical costs costsCost of diabetesEUR B , 2010>X21.21.3In 2007 the average cost ofdiabetes patients was EUR 4,443 /year in comparison to the nationalaverage of EUR 1,646 / yearX22-31.84-50.22.63.510-11Type 258%42%Type 1• Complications andlost productivity /welfare assumed100% distributedas insulin patients• Other costassumed 70%distributed asinsulin patientsand 30% totalpatients• Insulin patients:Type 1 ~45%Type 2 ~65%CommentsReportedmedicalcosts ( RIVM)Estimated byRIVMUnreportedcost ofcomplicationsBottom up BoozestimateCosts diabetestreatment andcomplicationsOthermedical costsfor diabetespatients 1)Difference betweenmedical costs forpatients with diabetesand medical costs fortreatment andcomplications ofdiabetesTotal medicalcosts fordiabetespatientsBased on totalmedical costsfor diabetespatients(NPCF )Absenteeism &presenteeismEffect of hyposon absence fromand inefficiencyat work, basedon ADF study(but numbersvary in differentpublications)WelfarepaymentsdisabledBased on 75% ofmodal income *and 98,000disabled withdiabetesLostproductivitydisabledBased on modalincome and98,000 disabledMedical andproductivitycosts diabetespatients1) Other unreported medical costs include costs caused by additional use of medical care by diabetes patients; 2007 estimateBooz & Company 14 November 2011 Prepared for Novo NordiskSource: NPCF, ADF, CBS, RIVM, SFK, DiabetesZorgBeter, Diabetes Richtlijnen, DBC pricelist 2011, Booz & Company Analysis1421
Page 6 and 7: SummaryDiabetes is a serious and de
Page 8: diabetes care. Extra compensation w
Page 11 and 12: ContentsSummarized findings and rec
Page 13 and 14: 11Diabetes is a major and underesti
Page 15 and 16: 33Further improving health of of di
Page 17 and 18: 22Recommendation 2: Engage employer
Page 19 and 20: 44Recommendation 4: Introduce condi
Page 21: Already more than 1M diabetes patie
Page 25 and 26: Number of patients reaches ~1.4M in
Page 27 and 28: Increase in lost productivity is dr
Page 29 and 30: Diabetes care clearly improved in t
Page 31 and 32: Better compliance can be stimulated
Page 37 and 38: Delaying complications saves medica
Page 39 and 40: LimitedLimitedcollaborationcollabor
Page 41 and 42: Individual quality incentives are l
Page 43 and 44: Recommendation 1: Insurer should in
Page 47 and 48: Labour shortage from late nineties
Page 49 and 50: However, curative and participative
Page 53 and 54: Non-compliance leads to severe comp
Page 55: Facilitated patient networks are su
Page 58 and 59: Recommendation 3:Facilitate network
Page 62 and 63: But new medication could add a lot
Page 66: Booz & Company is a global manageme

Diabetes Care in The Netherlands: - Novo Nordisk

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