Simple calculator to estimate the medical cost of diabetes in sub-Saharan Africa

AIM: To design a medical cost calculator and show that diabetes care is beyond reach of the majority particularlypatients with complications.METHODS: Out-of-pocket expenditures of patients for medical treatment of type-2 diabetes were estimated based on price data collected in Benin,Burkina Faso,Guinea and Mali. A detailed protocol for realistic medical care of diabetes and its complications in the African context was defined. Care components were based on existing guidelines,published data and clinical experience. Prices were obtained in public and private health facilities. The cost calculator used Excel. The cost for basic management of uncomplicated diabetes was calculated per person and per year. Incremental costs were also computed per annum for chronic complications and per episode for acute complications. RESULTS: Wide variations of estimated care costs were observed among countries and between the public and private healthcare system. The minimum estimated cost for the treatment of uncomplicated diabetes(in the public sector) would amount to 21%-34% of the country's gross national income per capita,26%-47% in the presence of retinopathy,and above 70% for nephropathy,the most expensive complication. CONCLUSION: The study provided objective evidence for the exorbitant medical cost of diabetes considering that no medical insurance is available in the study countries. Although the calculator only estimates the cost of inaction,it is innovative and of interest for several stakeholders.

The Economic Burden of Head and Neck Cancers in Denmark

Introduction: The incidence of head and neck cancers has increased markedly over the last decade. A Danish study of the costs of head and neck cancers has not been undertaken. Such studies have again become relevant due to the development of the HPV vaccines, as some cases are attributable to high-risk HPV 16 or 18. The objective of study was to estimate the incidence of head and neck cancers and their health care costs. Methods: Data on incidence and health care use related to head and neck cancer were obtained from Danish health care registers. New cancer patients were identified in the Danish National Cancer Register. Resource use per year in the hospital sector was estimated using data from the National Patient Register applying charges as cost estimates. Health care consumption by cancer patients was compared with that by an age- and sex-matched cohort without cancer. Results: We found that nearly 1000 new cases of oral cavity, oropharyngeal, hypopharyngeal and laryngeal cancer are diagnosed annually. In total the cost of these cancers to the Danish hospital sector constituted 31.6 million Euros per year, with the majority of costs (74%) occurring in men. The total costs associated with HPV16/18-related head and neck cancers were estimated to be 6.1 million Euros per year. Conclusion: This study provides the first Danish estimates of the costs associated with non-cervical and non-genital HPV-related cancers based on very reliable, individual-based data. It is expected that the current HPV vaccination programme will reduce this burden.

The Societal Cost of Schizophrenia in China from 2010 to 2024—A Literature Review

Background: Schizophrenia is a chronic disease related to long-lasting and tremendous effects on patient’s health in China, which is generally considered as a huge economic burden not only for patients but also for their caregivers and the whole society. Therefore, it is necessary to conduct an analysis of cost. Previous cost-of-illness (COI) studies have already provided some useful information on the economic burden that schizophrenia brought to global society, including China. Objectives: This systematic review aims to obtain a comprehensive understanding of the economic burden of schizophrenia in China. Method: A literature review was performed through CNKI, Wanfang, CQVIP, EMBASE and Medline databases to identify COI studies published between 2010-2024. The primary outcome of this review was societal cost per schizophrenia patient by cost component, including direct medical costs, non-medical costs and indirect medical costs. Results: 14 COI studies in schizophrenia were identified, covering 7 municipalities and 8 provinces of China. The annual societal cost per patient ranged from 10,765 CNY in Zhejiang province to 406,382 CNY in Xuancheng city (Anhui province). The ratio of indirect cost ranged from 66.6% to 96.8%. The main cost drivers were the productivity losses. There was an enormous heterogeneity between societal cost estimations that could be interpreted by the difference in economic state and regional healthcare resource allocation. Conclusions: This review highlights the large economic burden of schizophrenia in varied areas in China. Substantial cost variation was observed both nationwide and globally, which may be caused by the varied economic situation and healthcare policy. Limitation of this review was summarized, which may provide a useful guidance for the future COI studies in China.

Economic costs of hospitalized diarrheal disease in Bangladesh:a societal perspective

Background:Diarrheal diseases are a major threat to human health and still represent a leading cause of morbidity and mortality worldwide.Although the burden of the diarrheal diseases is much lower in developed countries,it is a significant public health problem in low and middle-income countries like Bangladesh.Though diarrhea is preventable and managed with low-cost interventions,it is still the leading cause of morbidity according to the patient who sought care from public hospitals in Bangladesh indicating that significant resources are consumed in treating those patients.The aim of the study is to capture the inpatients and outpatient treatment cost of diarrheal disease and to measure the cost burden and coping mechanisms associated with diarrheal illness.Methods:This study was conducted in six randomly selected district hospitals from six divisions(larger administrative units)in Bangladesh.The study was performed from the societal perspective which means all types of costs were identified,measured and valued no matter who incurred them.Cost analysis was estimated using the guideline proposed by the World Health Organization for estimating the economic burden of diarrheal diseases.The study adopted quantitative techniques to collect the household and hospital level data including structured and semi-structured questionnaires,observation checklists,analysis of hospital database,telephone interviews and compilation of service statistics.Results:The average total societal cost of illness per episode was BDT 5274.02(US$67.18)whereas the average inpatient and outpatient costs were BDT 8675.09(US$110.51)and BDT 1853.96(US$23.62)respectively.The cost burden was significantly highest for poorest households,21.45%of household income,compared to 4.21%of the richest quintile.Conclusions:Diarrheal diseases continue to be an overwhelming problem in Bangladesh.The economic impact of any public health interventions(either preventive or promotive)that can reduce the prevalence of diarrheal diseases can be estimated from the data generated from this study.

Economic costs of alcohol consumption in Thailand,2021

Background Alcohol is one of the leading risk factors contributing to avoidable economic loss worldwide.Estimates from the economic cost of alcohol consumption studies play an important role in prioritizing healthcare resource use,supporting policy decisions,and justifying budgets for alcohol policy.This study aimed to estimate the economic burden associated with alcohol consumption in Thailand in 2021.Methods Prevalence-based cost of illness methodology was employed.The following costs were included in the analysis:healthcare costs;cost of law enforcement;cost of property damage due to road traffic accidents;cost of premature mortality;and cost of absenteeism from out-patient hospital visits and hospitalization.Human capital approach was adopted.All costs were presented in Thai baht,2021.Results Alcohol consumption incurred a total estimated economic cost of 165,450.5 million baht,equivalent to 1.02%of Gross Domestic Product(GDP)and 2500 baht per capita.Cost of premature mortality was estimated at 157,918.7 million baht and accounted for the largest proportion of the total cost(95.45%).Healthcare cost was found to be the second highest share representing 4370.1 million baht(2.7%of the total cost).The number of premature death attributable to alcohol consumption in 2021 was estimated at 22,804.Conclusions Alcohol continues to impose a substantial economic burden in Thailand.Enforcement of existing wellformulated alcohol control policies is urgently required to mitigate the economic impact of alcohol consumption in the country.

Indirect costs associated with deaths from the Ebola virus disease in West Africa

Background:By 28 June 2015,there were a total of 11,234 deaths from the Ebola virus disease(EVD)in five West African countries(Guinea,Liberia,Mali,Nigeria and Sierra Leone).The objective of this study was to estimate the future productivity losses associated with EVD deaths in these West African countries,in order to encourage increased investments in national health systems.Methods:A cost-of-illness method was employed to calculate future non-health(NH)gross domestic product(GDP)(NHGDP)losses associated with EVD deaths.The future non-health GDP loss(NHGDPLoss)was discounted at 3%.Separate analyses were done for three different age groups(<=14 years,15–44 years and=>45 years)for the five countries(Guinea,Liberia,Mali,Nigeria,and Sierra Leone)affected by EVD.We also conducted a one-way sensitivity analysis at 5 and 10%discount rates to gauge their impacts on expected NHGDPLoss.Results:The discounted value of future NHGDPLoss due to the 11,234 deaths associated with EVD was estimated to be Int$(international dollars)155,663,244.About 27.86%of the loss would be borne by Guinea,34.84%by Liberia,0.10%by Mali,0.24%by Nigeria and 36.96%by Sierra Leone.About 27.27%of the loss is attributed to those aged under 14 years,66.27%to those aged 15–44 years and 6.46%to those aged over 45 years.The average NHGDPLoss per EVD death was estimated to be Int$17,473 for Guinea,Int$11,283 for Liberia,Int$25,126 for Mali,Int$47,364 for Nigeria and Int$14,633 for Sierra Leone.Conclusion:In spite of alluded limitations,the estimates of human and economic losses reported in this paper,in addition to those projected by the World Bank,show that EVD imposes a significant economic burden on the affected West African countries.That heavy burden,coupled with human rights and global security concerns,underscores the urgent need for increased domestic and external investments to enable Guinea,Liberia and Sierra Leone(and other vulnerable African countries)to develop resilient health systems,including core capacities to detect,assess,notify,verify and report events,and to respond to public health risks and emergencies.