The economic burden of diabetes in India: a review of the literature

Abstract

BackgroundDiabetes and its complications are a major cause of morbidity and mortality in India, and the prevalence of type 2 diabetes is on the rise. This calls for an assessment of the economic burden of the disease.ObjectiveTo conduct a critical review of the literature on cost of illness studies of diabetes and its complications in India.MethodsA comprehensive literature review addressing the study objective was conducted. An extraction table and a scoring system to assess the quality of the studies reviewed were developed.ResultsA total of nineteen articles from different regions of India met the study inclusion criteria. The third party payer perspective was the most common study design (17 articles) while fewer articles (n =2) reported on costs from a health system or societal perspective. All the articles included direct costs and only a few (n =4) provided estimates for indirect costs based on income loss for patients and carers. Drug costs proved to be a significant cost component in several studies (n =12). While middle and high-income groups had higher expenditure in absolute terms, costs constituted a higher proportion of income for the poor. The economic burden was highest among urban groups. The overall quality of the studies is low due to a number of methodological weaknesses. The most frequent epidemiological approach employed was the prevalence-based one (n =18) while costs were mainly estimated using a bottom up approach (n =15).ConclusionThe body of literature on the costs of diabetes and its complications in India provides a fragmented picture that has mostly concentrated on the direct costs borne by individuals rather than the healthcare system. There is a need to develop a robust methodology to perform methodologically rigorous and transparent cost of illness studies to inform policy decisions.

Oral glucose tolerance test significantly impacts the prevalence of abnormal glucose tolerance among Indian women with polycystic ovary syndrome: lessons from a large database of two tertiary care centers on the Indian subcontinent

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“…3 An estimated US$ 2.2 billion would be needed to sufficiently treat all cases of type 2 diabetes mellitus (T2DM) in India. 10 India currently faces an uncertain future in relation to the potential burden that diabetes may impose on the country. It is very important to conduct studies focusing on economic evaluations to make evidence based health decisions and, consequently, to offer the best risk and cost-effective treatment choices along with better quality of life for patients with diabetes.…”

Comparison of the Length of Stay and Medical Expenditures among Japanese Hospitals for Type 2 Diabetes Treatments: The Box-Cox Transformation Model under Heteroscedasticity

“…Condliffe, Parasuraman and Pollack [11] reported that medical expenditures for diabetes patients with comorbid hypertension and obesity were significantly higher than those of patients without these comorbidities. Yesudian et al [12] summarized the literature about the economic burden of diabetes in India. In addition to the medical costs, diabetes reduces the labor supply and the productivity of patients.…”