Cost of diabetes care in out-patient clinics of Karachi, Pakistan

Abstract

BackgroundDiabetes Mellitus (DM) is a growing epidemic and the cost of treating diabetes is largely increasing. The objective of this study was to estimate the cost-of-illness of DM among attendees of out-patient clinics in Karachi, Pakistan. This is the first study conducted from a societal perspective to estimate the cost of managing diabetes in Pakistan.MethodsA prevalence-based 'Cost-of-Illness' study for diabetes care was conducted in six different out-patient clinics of Karachi, Pakistan from July to September 2006. A pre-tested questionnaire was administered to collect the data from 345 randomly selected persons with diabetes.ResultsThe annual mean direct cost for each person with diabetes was estimated to be Pakistani rupees 11,580 (US$ 197). Medicines accounted for the largest share of direct cost (46%), followed by laboratory investigations (32%). We found that increased age, the number of complications and longer duration of the disease significantly increase the burden of cost on society (p < 0.001). Comparing cost with family income it was found that the poorest segment of society is spending 18% of total family income on diabetes care.ConclusionThis study concluded that substantial expenditure is incurred by people with diabetes; with the implication that resources could be saved by prevention, earlier detection and a reduction in diabetes co-morbidities and complications through improved diabetes care. Large scale and cost-effective prevention programs need to be initiated to maximise health gains and to reverse the advance of this epidemic.

The economic costs of diabetes in developing countries: some concerns and recommendations

“…Moreover, the authors identified medications and devices as the most expensive component of direct costs. These results are consistent with other researchers' findings and estimates from developing countries [5,6]. Nevertheless, we are concerned that these results may underestimate the economic cost of diabetes in Iran.…”

“…Diabetes is the fourth leading cause of death by diseases worldwide; more than one million people died from diabetes in 2005 and almost 80% of these deaths occurred in low-and middle-income countries [3,4]. Due to the premature disability, morbidity and mortality associated with diabetes, diabetes is one of the most costly diseases to manage [5,6]. This burden is even more of a problem in developing countries where diabetes and associated cardiovascular diseases develop at earlier ages and with greater severity [7].…”

The economic costs of diabetes: a population-based study in Tehran, Iran

“…Taken together, it seems that the costs of diabetes generally increase in relation to a country's degree of economic development and gross domestic product. In our neighbouring country, in a recent study of outpatient clinics in Karachi (Pakistan) [14], with a sample of 345 randomly selected diabetic patients, annual mean direct costs for a person with diabetes were estimated to be $197. This study did not consider excess costs attributable to diabetes, and hospitalisation costs were also not included.…”

Prevalence and Associated Factors of Depression among Type 2 Diabetes Mellitus Patients on Follow up at Ambo General Hospital, Oromia Regional State, Ethiopia, Institutional Based Cross Sectional Study

“…Similarly, depression affects all populations worldwide, but more than two-thirds of the affected people live in developing countries [2]. Both diabetes and depression are associated with premature morbidity and mortality, and when these conditions co-exist, the risk of developing co-morbidities, complications, patient suffering and associated cost, escalates [3,4].…”

“…Similarly, depression affects all populations worldwide, but more than two-thirds of the affected people live in developing countries [2]. Both diabetes and depression are associated with premature morbidity and mortality, and when these conditions co-exist, the risk of developing co-morbidities, complications, patient suffering and associated cost, escalates [3,4].Depression is a significant contributor to the global burden of disease and affects people in all communities across the world. Depressive disorders often start at a young age; they reduce people's functioning and often are recurring.…”