The Financial Burden of Diabetes Mellitus Type 1 And Type 2 In Egypt

• Published in: Value in health 2017-10, Vol.20 (9), p.A477
• Main Authors: Assaad-Khalil, S, Elebrashy, IN, Afify, Y, Abdelmordy, B, Zakaria, W, Aboushady, R, Zanaty, S, Basiouny, E, Ibrahim, A, Sallam, R, Anan, I
• Format: Article
• Language: English
• Subjects: Absenteeism; Amputation; Autoimmune diseases; Complications; Diabetes; Diabetes mellitus; Diabetes mellitus (insulin dependent); Diabetes mellitus (non-insulin dependent); Disease management; Drug prices; Drugs; Glycemic control; Health care expenditures; Health economics; Hospitalization; Indirect costs; Medical treatment; Mortality; Premature mortality; Primary care; Private sector; Productivity; Type 1 diabetes mellitus; Type 2 diabetes mellitus
• ISSN: 1098-3015; 1524-4733
• DOI: 10.1016/j.jval.2017.08.447

OBJECTIVES: Diabetes Mellitus (DM) imposes a huge economic burden on individuals, families, health care systems and countries. This cost of illness study aims to calculate the direct and indirect costs incurred by both governmental and private sectors in Egypt during 2016. METHODS: Both, top-down and bottom-up approaches were used. Data was collected from: the governmental sectors for spending on diabetes management, retail audit data for medication costs spent on both diabetes and its complications by private sector, interviews with five thousand DM subjects conducted nationwide stating direct medical costs and productivity loss as indirect cost, premature mortality cost was calculated from cause of mortality reports and the average daily wage from Egyptian reports. RESULTS: Total cost of Diabetes was calculated to be (EGP 25.2 billion) equivalent to (USD 3.5 billion), using the exchange rate of EGP 1 - USD 0.13976. The direct medical cost was calculated to be (EGP 22.3 billion), where DM complications management cost recorded the highest share (65%) representing (EGP 14.4 billion). The cost of DM medications was (EGP 2.5 billion), cost of hospitalization and amputation was (EGP 1.6 billion), and cost of investigations and monitoring was (EGP 3.7 billion). Indirect cost was calculated to be (EGP 2.9 billion), with highest share caused by absenteeism (EGP 2.1 billion) and premature mortality (EGP 740 million). CONCLUSIONS: The highest burden on both governmental and private sectors was attributed to the management of complications cost. More effort should be exerted to decrease the cost of complications in order to lower the diabetes burden in Egypt. This can be achieved by reaching higher level of glycemic control of subjects with DM, through more awareness, adherence and monitoring programs at the primary care units, increasing the number of diabetic educators, and focusing on DM treatment protocols that provide more glycemic control.