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Estimation of the direct cost of diabetes in the Arab region

Abstract

BACKGROUND: Diabetes needs costly prolonged treatment and care. Its burden affects the whole society. Six of the top 10 countries with the highest prevalence of diabetes are in the Middle East. Following the studies carried out in Latin America and the Caribbean countries, and in the WHO African region, an estimation of the direct cost of diabetes in the Arab region is proposed. METHOD: Arab countries were classified into three income groups. The prevalence of diabetes was estimated in each country. The direct cost of diabetes included the cost of insulin, oral drugs, reagent strips, urine strips, lancets, glucose meters, laboratory tests, outpatient consultation and hospitalization. To overcome the problem of disparity in prices, three scenarios were used (Low, Medium and High price). RESULTS: The annual average per capita direct cost of diabetes is estimated in US dollars at USD 351, USD 529 and USD 860 according to the low, medium and high cost scenarios, respectively. The cost varies also according to the income group. The annual total direct cost of diabetes in the 21 countries of the Arab world is estimated to be between USD 9 billion and USD 22 billion. The annual average per capita direct cost of diabetes in the Arab region is 1.4 to 3.5 times higher than the average per capita health expenditure of the region (USD 250). The direct cost of diabetes in the third income group is 4.8 to 11.4 higher than the average per capita health expenditure of the group (USD 66.5) whereas, in the first group, the ratio is 0.4 to 1.14. Although indirect cost is not considered in this paper, it is stressed that diabetes also incurs indirect costs due to loss of productivity caused by premature death and disability, and intangible and non-quantifiable costs. CONCLUSION: This study shows that the direct cost of diabetes is high compared to health expenditure in Arab countries. A sincere call is sent to health decision makers to give more importance to sensitisation, early diagnosis and treatment of diabetes.