Catastrophic pharmaceutical expenditure in patients with type 2 diabetes in Iran

Abstract

Objectives This study aimed to assess the financial burden of out-of-pocket (OOP) payments to purchase antidiabetic medicines for type 2 patients in Iran. Method The “budget share” and “capacity to pay” approaches were employed to assess the catastrophic pharmaceutical expenditures of antidiabetic medication therapies. The catastrophic thresholds were adjusted for pharmaceutical sectors. The data was 2019 monthly household expenditures in rural and urban areas, insurance coverages of antidiabetic medicines and patients' out-of-pocket (OOP) payments in 30-day treatment schedules. Results The results show that expenditure on diabetes medication therapies in the form of mono-dual therapy and some cases triple oral therapies were not catastrophic even for rural households. Insulin puts patients at risk of catastrophic pharmaceutical expenditures when added to the treatment schedules, and lack of financial protection intensifies it. In general, the poorer households and those resistant to first-line treatments were at increased risk of catastrophic pharmaceutical expenditures. The number of treatments that put patients at risk of catastrophic pharmaceutical expenditure in "budget share" was higher than the "capacity to pay" approach. Conclusions Assessing medication treatment affordability instead of a single medicine assessment is needed. Assessment could be done by utilizing a macro-level data approach and applying adjusted pharmaceutical sector threshold values. Considering the variation between treatment schedules that put patients at risk of catastrophic pharmaceutical expenditures, targeted pharmaceutical policies and reimbursement decisions are recommended to promote Universal Health Coverage (UHC) and to protect vulnerable populations from hardship.

Factors Associated with Unmet Needs of Chronic Diseases in Kenya: Multilevel Analysis of Kenya Household Health Expenditure and Utilization Survey 2018

“…This coincides with health and macroeconomists, who view health as a commodity that is procured by a family as one unit (Adeniji et al, 2022;Goodman et al, 1999). This may mean that factors that hinder chronically ill individuals can be addressed at the household level (Adeniji et al, 2022;Park et al, 2023;Zarei et al, 2022). The study revealed that females were more susceptible to facing unmet needs.…”