Diabetes imposes a substantial economic burden on countries, health systems, people with diabetes, and their families.39–41
Direct costs of diabetes
Direct costs are the health expenditures that occur due to diabetes – regardless of whether the expenditure is borne out of pocket by people living with diabetes or by private or public payers, including governments. The IDF Diabetes Atlas has included estimates of health expenditure due to diabetes42–47 since its 3rd edition in 2006. The increase in global health expenditure due to diabetes has been considerable, growing from USD 232 billion in 2007 to USD 966 billion in 2021 for adults aged 20–79 years (Figure 3.14).
Regional distribution
The NAC Region has the highest total diabetes-related health expenditure of the seven IDF Regions (USD 415 billion), and accounts for 42.9% of total global diabetes- related health expenditure in 2021. The second highest is the WP Region with USD 241.3 billion, followed by the EUR Region (USD 189 billion) corresponding to 25.0%
and 19.6% of the total global diabetes-related health expenditure, respectively. Despite being home to 40.8%
of people with diabetes in the world, the SACA, MENA, AFR, and SEA Regions are collectively responsible for only 12.5% of global diabetes-related health expenditure (Figure 3.15).
The NAC Region also has the highest diabetes-related health expenditure per adult with diabetes (USD 8,209),
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Figure 3.14 Total diabetes-related health expenditure for adults (20–79 years) with diabetes from 2006 to 2045
Figure 3.15 Total diabetes-related health expenditure (USD billion) in adults with diabetes (20–79 years) in 2021 by IDF Region
Figure 3.16 Diabetes-related health expenditure (USD) per person with diabetes (20–79 years) in 2021 by IDF Region
IDF: International Diabetes Federation; AFR: Africa; EUR: Europe;
MENA: Middle East and North Africa; NAC: North America and Caribbean; SACA: South and Central America; SEA: South-East Asia;
WP: Western Pacific
IDF: International Diabetes Federation; AFR: Africa; EUR: Europe;
MENA: Middle East and North Africa; NAC: North America and Caribbean; SACA: South and Central America; SEA: South-East Asia;
WP: Western Pacific
Diabetes-related health expenditure as a
percentage of Gross Domestic Product (GDP) is highest in the SACA Region at 1.71%, followed by 1.69% in the NAC Region (Figure 3.18). When considering World Bank income classification, diabetes-related health expenditure as a percentage of GDP is highest amongst high-income countries (1.16%), followed by middle- income countries (1.08%), and followed distantly by low-income countries (0.51%) (Figure 3.19).
0 200 800 1200
Year 400
600 1000
USD billion
2006 2009 2011 2013 2015 2017 2019 2021
Figure 3.14
2045 2030
IDF Regions Diabetes-related health expenditures per person (USD)
0 1000 2000 3000 4000 5000 6000 7000 8000
NAC EUR SACA WP MENA AFR SEA
9000 Figure 3.16
IDF Regions Total diabetes-related health expenditure (USD billion)
0 50 100 150 200 250 300 350 400
NAC WP EUR SACA MENA AFR SEA
450 Figure 3.15
Country distribution
On a country level, the highest diabetes-related health expenditure is observed in the United States of America (USD 379.5 billion), followed by China and Brazil, (USD 165.3 billion and USD 42.9 billion, respectively) (Table 3.22).
The countries with the lowest diabetes-related health expenditure in 2021 are Gambia and Nauru, with total expenditure of USD 2.4 million and USD 1.6 million, respectively (Map 3.9).
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IDF Regions
Percentage of GDP (%)
0.00 0.20 0.40 0.60 0.80 1.00 1.20 1.40 1.60 1.80
Figure 3.18 2.00
AFR EUR MENA
NAC WP SEA
SACA Figure 3.17
IDF Regions
%
0 5 10 15 20
AFR EUR
MENA WP NAC SEA
SACA
Figure 3.17 Percentage of diabetes-related health expenditure for adults (20–79 years) with diabetes, by IDF Region in 2021
Figure 3.18 Diabetes-related health expenditure as a percentage of Gross Domestic Product (GDP), by IDF region
IDF: International Diabetes Federation; AFR: Africa; EUR: Europe;
MENA: Middle East and North Africa; NAC: North America and Caribbean; SACA: South and Central America; SEA: South-East Asia;
WP: Western Pacific
IDF: International Diabetes Federation; AFR: Africa; EUR: Europe;
MENA: Middle East and North Africa; NAC: North America and Caribbean; SACA: South and Central America; SEA: South-East Asia;
WP: Western Pacific
Figure 3.19 Diabetes-related health expenditure as a percentage of Gross Domestic Product (GDP), by World Bank income classification
0.40 0.60 0.80 1.00 1.20 1.40
Percentage of GDP (%)
Figure 3.19
Table 3.22 Ten countries or territories with the highest total health expenditure (USD) due to diabetes (20–79 years) in 2021
Rank Country or territory Total diabetes-related health expenditure in 2021 (USD billion) in adults (20–79 years) 1 United States of
America 379.5
2 China 165.3
3 Brazil 42.9
1
>5,000
Map heading Full colour range for legend Full colour range
2,000-<5,000
1,000-<2,000
500-<1,000
250-<500
<250
<0 (No estimates made)
>0%
>0%
>0%
>0%
>0%
>0%
<0%
<0%
<250 250-<500 500-<1,000 1,000-<2,000 2,000-<5,000
>5,000 no estimates made
3
Map 3.9 Total diabetes-related health expenditure (USD) for adults (20–79 years) with diabetes, 2021
Map 3.10 Diabetes-related health expenditure (USD) per person with diabetes (20–79 years) in 2021
>5,000
Map heading Full colour range for legend Full colour range
2,000-<5,000
1,000-<2,000
500-<1,000
250-<500
<250
<0 (No estimates made)
>0%
>0%
>0%
>0%
>0%
>0%
<0%
<0%
<10 million 10-<50 million 50-<200 million 200 million-<1 billion 1-<10 billion
>10 billion no estimates made
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In 2021, huge disparities exist among countries in per person diabetes-related health expenditure. The countries with the highest yearly expenditure per person are Switzerland (USD 12,828), followed by the United States of America (USD 11,779) and Norway (USD 11,166). Countries with the lowest annual expenditure per person are The Democratic Republic of the Congo (USD 94), Pakistan (USD 80) and Bangladesh (USD 77) (Map 3.10).
Of the 10 countries with the highest health expenditure for diabetes per person, nine are from the EUR Region and one is from the NAC Region (Table 3.23).
Table 3.23 Top 10 countries or territories for diabetes- related health expenditure (USD) per person with diabetes (20–79 years) in 2021
Rank Country or territory Diabetes-related