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Direct and Indirect Costs Associated with Coronary Artery (Heart) Disease in Tabriz, Iran
Shahla Darba1, Naser Safaei2, Alireza Mahboub-Ahari3
1Department of Health Economics, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
Insights
The total annual cost of coronary artery disease (CAD) in Iran is estimated at $7,736 per patient, with direct medical costs being the largest component. This highlights the significant economic burden of CAD, emphasizing the need for effective healthcare policies.
Area of Science:
- Health Economics
- Public Health
- Cardiology
Background:
- Cardiovascular diseases (CVDs) represent a leading cause of global mortality.
- Coronary Artery Disease (CAD) imposes a substantial economic burden on healthcare systems worldwide.
Purpose of the Study:
- To evaluate the direct and indirect costs associated with Coronary Artery Disease (CAD) in Iran.
- To determine the economic burden of CAD from a societal perspective.
Main Methods:
- A prevalence-based cost-of-illness (COI) study was conducted over six months in 2017.
- Direct costs were calculated using a bottom-up approach, and indirect costs were estimated via the Human Capital (HC) approach.
- Generalized linear regression models and sensitivity analysis were employed to assess costs and their determinants.
Main Results:
- The estimated total annual cost per patient with CAD in Iran was $7,736 (PPP).
- Direct medical costs constituted the largest portion (54%) of the total cost, followed by indirect costs (44%), primarily due to work absenteeism.
- Direct non-medical costs accounted for 2% of the total expenditure.
Conclusions:
- CAD incurs significant direct and indirect economic costs in Iran, representing a substantial portion of the GDP.
- Understanding the cost drivers is crucial for effective healthcare policy-making, priority setting, and cost-benefit analyses.
- The findings support the need for improved insurance coverage and equity in managing CAD.
Purpose:
Cardiovascular diseases (CVDs) are the major causes of mortalities worldwide. This study was conducted to evaluate the direct and indirect costs of coronary artery disease (CAD) in Iran.
Patients And Methods:
This is a prevalence-based cost-of-illness (COI) study that estimates the direct and indirect costs of CAD. The study conducted over a six-month period from April to September in 2017. Patients were recruited from Madani hospital in Tabriz, Iran. A total of 379 patients were investigated from societal perspective. Direct costs were estimated using the bottom-up costing approach and indirect costs were estimated using the Human Capital (HC) approach. A generalized linear model of regression was used to explore the relation between total cost and socio-demographic variables. The total annual mean cost was compared to Gross Domestic Product (GDP) per capita which was reported in the form of Purchasing Power Parity (PPP) index. To deal with uncertainty, one-way sensitivity analysis was performed.
Results:
Total costs per patient in one year were estimated to be IRR 63452290.17 ($PPP 7736.19) at a 95% confidence interval (58191511.73-68713068.60), the biggest part of which is related to direct medical costs with IRR 33884019.53 per year ($PPP 4131.18) (54%). Direct non-medical costs were estimated IRR 1655936.68 ($PPP 201.89) per patient (2%) and indirect costs were estimated IRR 27912333.97 per patient ($PPP 3403.11) (44%), which 62% of indirect costs is related to patients' work absenteeism.
Conclusion:
This study estimates the direct (56%) and indirect (44%) costs associated with CAD. The study explores the essential drivers of the costs and provides the magnitude of the burden in terms of the share of GDP. The outcomes can be used in priority setting, in particular for cost benefit analysis, and adopting new policies regarding insurance coverage and equity issues.
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