Ian F Walker1, Fredrike Garbe2, Judy Wright3, Ian Newell4, Naveen Athiraman5, Nida Khan6, Helen Elsey2. 1. Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK. Electronic address: i.walker@leeds.ac.uk. 2. Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK. 3. Leeds Institute of Health Sciences, University of Leeds, Leeds, UK. 4. Faculty of Medicine, University of Birmingham, Birmingham, UK. 5. Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK. 6. Association for Social Development, Islamabad, Pakistan.
Abstract
BACKGROUND: More than 80% of global deaths caused by cardiovascular disease (CVD) and diabetes mellitus (DM) occur in developing countries. The burden of noncommunicable disease in South Asia is increasing rapidly. OBJECTIVES: To estimate the costs of CVD and the costs of DM to individuals and society in Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka. METHODS: We systematically searched six health and economic databases for studies identifying costs related to CVD or DM and their respective complications. Costs were extracted from included studies and converted to US $ for the price year 2015 to enable meaningful comparisons. RESULTS: Of the 71 articles suitable for full-text review, 29 studies met the inclusion criteria. Most were cost-of-illness studies (n = 27) and were from the patient perspective (n = 23). Most collected data since 2000 (n = 23) and included data from India (n = 24). No studies included longitudinal costs at the patient level. Medical costs for routine management of CVD and DM were broadly similar. These costs escalate significantly once complications occur, which require treatment, particularly for stroke, major coronary events, and amputations. Costs are mainly borne by the individual and family. Some included studies modeled rapidly rising future costs. Most studies included had methodological weaknesses. CONCLUSIONS: Marked increases in costs have been identified when complications of these chronic diseases occur, underlining the importance of secondary prevention approaches in disease management in South Asia. Higher quality studies, especially those that include longitudinal costs, are required to establish more robust cost estimates.
BACKGROUND: More than 80% of global deaths caused by cardiovascular disease (CVD) and diabetes mellitus (DM) occur in developing countries. The burden of noncommunicable disease in South Asia is increasing rapidly. OBJECTIVES: To estimate the costs of CVD and the costs of DM to individuals and society in Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka. METHODS: We systematically searched six health and economic databases for studies identifying costs related to CVD or DM and their respective complications. Costs were extracted from included studies and converted to US $ for the price year 2015 to enable meaningful comparisons. RESULTS: Of the 71 articles suitable for full-text review, 29 studies met the inclusion criteria. Most were cost-of-illness studies (n = 27) and were from the patient perspective (n = 23). Most collected data since 2000 (n = 23) and included data from India (n = 24). No studies included longitudinal costs at the patient level. Medical costs for routine management of CVD and DM were broadly similar. These costs escalate significantly once complications occur, which require treatment, particularly for stroke, major coronary events, and amputations. Costs are mainly borne by the individual and family. Some included studies modeled rapidly rising future costs. Most studies included had methodological weaknesses. CONCLUSIONS: Marked increases in costs have been identified when complications of these chronic diseases occur, underlining the importance of secondary prevention approaches in disease management in South Asia. Higher quality studies, especially those that include longitudinal costs, are required to establish more robust cost estimates.
Authors: Fiorella Pia Salvatore; Alessia Spada; Francesca Fortunato; Demetris Vrontis; Mariantonietta Fiore Journal: Int J Environ Res Public Health Date: 2021-04-27 Impact factor: 3.390
Authors: M Rozaini Rosli; Chin F Neoh; David B Wu; Nazariah W Hassan; Mahani Mahmud; Afifah Rahimi; Mahmathi Karuppannan Journal: Pharm Pract (Granada) Date: 2021-09-09
Authors: Bhavani Shankara Bagepally; Usa Chaikledkaew; Yogesh Krishnarao Gurav; Thunyarat Anothaisintawee; Sitaporn Youngkong; Nathorn Chaiyakunapruk; Mark McEvoy; John Attia; Ammarin Thakkinstian Journal: BMJ Open Diabetes Res Care Date: 2020-07