WASHINGTON — If 80% of Americans with type 2 diabetes met treatment goals, over $150 billion in medical costs would be saved over the next 30 years, Dr. Robert A. Rizza said in his presidential address at the annual scientific sessions of the American Diabetes Association.
If 80% of patients achieved just five goals—a hemoglobin A1c less than 7%, blood pressure less than 130/80 mm Hg, LDL cholesterol below 100 mg/dL, HDL greater than 40 mg/dL for men and greater than 50 mg/dL for women, and use of a daily baby aspirin—there would be 5 million fewer heart attacks, 600,000 fewer strokes, 1.2 million fewer cases of renal failure, 1.8 million fewer cases of blindness/eye surgery, and 1.8 million fewer premature deaths. The increased costs of achieving the goals would be offset by the savings that result from prevention of the complications, explained Dr. Rizza, of the Mayo Clinic, Rochester, Minn., who just completed his term as ADA's president, medicine & science.
Investigators used a large-scale mathematical model with equations that simulate metabolic pathway and processes leading to complications, called Archimedes (www.archimedesmodel.com
Archimedes also predicted that if 80% of type 2 diabetics took a daily generic “polypill” consisting of 1,000 mg metformin, 75 mg aspirin, 40 mg statin, and 10 mg of an ACE inhibitor, the number of heart attacks over the next 30 years would drop by 50%, renal failure by 4%, and blindness and eye surgery by 33%. Such a pill—with an all-generic formulation—would cost $100 per year while saving about $400 per year. And even if the treatments cost $500, the health care system would still see a savings within 5 years.
“It costs less to properly treat diabetes than it does to treat the complications that you get if you don't properly treat diabetes. It's a wise investment no matter how you look at it,” he said.
A cure for diabetes would go much farther, saving 8.4 million lives and preventing 41 million serious diabetes-related complications over 30 years. In the absence of a cure, the U.S. health care system will spend $6.6 trillion on diabetes complications over the next 30 years. A cure would save over $700 billion, suggesting there is a powerful financial incentive for a cure.
Dr. Rizza outlined a four-point proposal that the ADA plans to issue:
▸ America must invest heavily in diabetes research aimed at finding a cure.
▸ The size of the investment must be commensurate with the risk that diabetes represents to the country.
▸ Financial support must be established to sustain systems that ensure every person with diabetes the best possible care.
▸ And a message for physicians: “We must all renew our commitment to our patients, acknowledge that the current level of care for people with diabetes is simply not acceptable, and do everything in our power to make it better.”