Prevention and control of non-communicable diseases in iran: the case for Investment

Abstract

Background Non-communicable diseases are imposing a considerable burden on Iran. This study aims to assess the Return on Investment (ROI) for implementation of Non-communicable diseases (NCDs) prevention program in Iran. Methods Four disease groups including cardiovascular diseases, diabetes, cancer, and respiratory diseases were included in our ROI analysis. The study followed four steps: 1) Estimating the total economic burden of NCDs using the Cost-of-Illness approach. 2) Estimating the total costs of implementing clinical and preventive interventions using an ingredient based costing at delivering level and a program costing method at central level.3) Calculating health impacts and economic benefits of interventions using the impact measures of avoided incidence, avoided mortality, healthy life years (HLYs) gained, and avoided direct treatment costs. 4) Calculating the ROI for each intervention in 5- and 15- year time horizons. Results The total economic burden of NCDs to the Iranian economy was IRR 838.49 trillion per year (2018), which was equivalent to 5% of the country’s annual Gross Domestic Product (GDP). The package of NCD will lead to 549 000 deaths averted and 2 370 000 healthy life years gained over 15 years, and, financially, Iranian economy will gain IRR 542.22 trillion over 15 years. The highest ROI was observed for the package of physical activity interventions, followed by the interventions addressing salt, tobacco package and clinical interventions. Conclusions NCDs in Iran are causing a surge in health care costs and are contributing to reduced productivity. Those actions to prevent NCDs in Iran, as well as yielding to a notable health impact, are giving a good economic return to the society. This study underscores an essential need for establishment of a national multi-sectorial NCD coordination mechanism to bring together and strengthen existing cross-agency initiatives on NCDs.

Risk of incident cardiovascular diseases at national and subnational levels in Iran from 2000 to 2016 and projection through 2030: Insights from Iran STEPS surveys

“…However, the steady increase in CVD risk in Iran mandates further policies to address this issue. Public health policies to improve physical activity, followed by the interventions addressing salt intake, and tobacco cessation package has been shown as most cost-effective interventions to decrease CVDs in Iran [ 47 ].…”

Cohort profile: the PERSIAN Dena Cohort Study (PDCS) of non-communicable diseases in Southwest Iran

“…Large population-based prospective cohort studies are ideal for investigating the effects of lifestyle factors, genetic predisposition, and socioeconomic, occupational, and psychological factors on the incidence of NCDs. Accordingly, there should be a plan for early diagnosis and prevention of NCDs (especially for the elderly), reducing health costs and increasing the quality of life 12–14. Finally, even though NCDs have a substantial influence on both the economy and the health of Iran, public health institutions and the general population in Iran still need to give sufficient attention to these issues.…”

How does the problem-oriented innovation system (PIS) help in the management of cardiovascular diseases?

“…There is also evidence that the incidence of coronary heart diseases ( 11 ) and cardiovascular diseases are increasing in Iran ( 9 ). On the other hand, Iran is facing an increasing trend with the increase of its older adult population ( 12 ) and with increasing age, death due to cardiovascular diseases increases ( 13 ). Considering the need to reduce premature death by 25% from non-communicable diseases by 2025, the Iranian government has been tasked with creating a coordinated national strategy to reduce the burden of cardiovascular diseases ( 14 ).…”