PNS38 Towards a Healthcare Cost Catalogue for Middle EAST and North Africa: A Systematic Review of Costs Reported in Health Economic Publications from Jordan, Lebanon Palestine and Syria 1995-2019

Abstract

To review the costs of illness and unit costs published in health economic papers from Jordan, Lebanon Palestine and Syria, as part of a project systematically reviewing health economic research in 17 countries from the Middle East North Africa (MENA) region. PRISMA guidelines were followed. A Pubmed search was conducted up to 15th December 2019. English language full-text articles of original research on humans were included if the local population from Jordan, Lebanon, Palestine or Syria was involved and unit- or composite costs items for 1995-2019 were reported. Eligible studies from previous systematic reviews from MENA were also included. All data were extracted in a multi-stage peer-review process involving two researchers. From 1646 citations of full-text English articles and 3 systematic reviews, we identified 185 eligible papers reporting costs from MENA. Out of those, 20 (10.8%) reported costs primarily from Jordan (n=12, 60%), followed by Palestine (n=4, 20%) and Syria (n=2, 10%). Two papers (10%) were multi-country studies, including also Lebanon. Altogether 45% of the papers reported health outcomes, and 670 cost items were reported from the four countries. The costing year was 2015-2019 for 37.5% of the cost items. Most costs were reported for coronary heart disease (n=64, 9.6%), followed by colorectal cancer (n=38, 5.7%) and Hepatitis-A infection (n=26, 3.9%). From all cost items 66.0%, 7.6%, 1.0%, and 25.4% were direct healthcare-, direct non-healthcare-, indirect-, and total-costs, respectively. The source was primary research for 89.7% of the costs, secondary local data for 1.6%, secondary foreign data for 0.8%, modelling for 5.2%, and assumption for 2.7%. There is a scarcity of healthcare costs data in the four countries and mainly direct healthcare costs were reported. Multi-country studies allowing inter-country comparisons and transferability analyses in the region are encouraged to speed up the availability of input data for health economic research.