Economic Burden Of Non-communicable Diseases Research Articles

Evaluating Health Policy Effectiveness in Reducing the Economic Burden of Non-Communicable Diseases in Bangladesh

Non-communicable diseases (NCDs) represent a significant and growing public health challenge in Bangladesh, contributing to a substantial economic burden. Non-communicable diseases (NCDs), including cardiovascular diseases, diabetes, chronic kidney disease, cancers, and chronic respiratory conditions, represent a major health challenge in Bangladesh, contributing to substantial morbidity, mortality, and economic burden. The economic impact is profound, affecting both individuals and the broader economy through healthcare costs, loss of productivity, and long-term financial strain. This review aims to evaluate the effectiveness of health policies in mitigating the economic burden of NCDs in Bangladesh. The article begins with an overview of the prevalence and risk factors associated with NCDs, followed by an examination of the national health policies aimed at prevention, treatment, and management. The evaluation considers both successes and challenges, with a focus on policy implementation, healthcare financing, and access to care. Case studies highlight specific policy interventions that have demonstrated measurable success in reducing NCD prevalence and associated costs. The findings suggest that while significant progress has been made in policy formulation, challenges remain in ensuring comprehensive implementation and equitable access to healthcare services. Cost-effective strategies, such as scaling up preventive measures and improving healthcare infrastructure, are essential for reducing the economic burden of NCDs. The review concludes with recommendations for strengthening existing policies and exploring innovative approaches to sustain and enhance the impact of health policies on NCD management in Bangladesh.

The Role of Young Doctors' Health Parliament as an effective policy tool in Tackling NCDs: An innovative approach

Non-communicable diseases (NCDs) are increasingly recognized as a severe public health concern threatening the human race, development, and quality of life. In the last three decades, Years of healthy life lost due to disability (YLD) has witnessed a significant shift from Communicable diseases towards NCDs and injuries (1). Globally, the economic burden of NCDs is projected to rise to over 13 trillion dollars by the year 2030, and every 10% hike in NCDs is expected to cause a 0.5% decline in global economic growth(2). The poor and disadvantaged population is disproportionately affected by NCDs, contributing to increased health disparities within and between nations (3). In low- and middle-income countries like India, NCDs are expected to diminish their GDP by 1% to 5% annually(3). The novel concept of the Young Doctors' Health Parliament (YDHP) is uniquely positioned to leverage the fresh perspectives and energetic engagement of young medical professionals who are at the forefront of encountering and managing NCDs. This article explores how the Young Doctors' Health Parliament serves as a pivotal mechanism for young doctors to influence health policy, thereby playing a crucial role in mitigating the NCD burden that disproportionately affects their peers and younger generations.

Coping with the economic burden of non-communicable diseases among hypertensive and diabetic patients in private and public health facilities in Ado-Ekiti, Nigeria.

To assess and compare how private and public health facilities patients cope with the economic burden of non-communicable diseases. Comparative cross-sectional study. Thirty-nine private and eleven public health facilities in Ado-Ekiti, Nigeria. Three hundred and forty-eight (Private:173; Public:175) patients with hypertension or diabetes, or both were recruited. Specific coping methods and numbers of coping strategies used by participants, as well as the perceived ability of participants to cope with the economic burden of non-communicable diseases. Majority of participants paid through out-of-pocket (OOP) than through health insurance(HI) (Private:OOP:90.2% HI:9.8%; Public:OOP:94.3% HI:5.7%; p=0.152). More participants in private used instalment payments(p<0.001). However, other coping strategies showed no significant difference in both groups(p>0.05). Delayed treatment (Private:102; Public:95) was the most used strategy in both arms, and the number of strategies used by the participants showed no significant difference(p=0.061). Lower levels of education, out-of-pocket payment, increasing number of clinic visits, and hospital admission were associated with the use of higher numbers of coping strategies in both groups while being female and retired/unemployed were associated with the private arm. Although most patients in both groups pay out-of-pocket and use detrimental coping strategies, more patients in private arm use instalment payment, a non-detrimental method. Healthcare providers, especially public providers, should adopt policies encouraging patients to use non-detrimental coping strategies to meet their healthcare expenditures. None declared.

Economic burden of non-communicable diseases on households in Nigeria: evidence from the Nigeria living standard survey 2018-19.

The importance of non-communicable diseases (NCDs) in Nigeria is reflected in their growing burden that is fast overtaking that of infectious diseases. As most NCD care is paid for through out-of-pocket (OOP) expenses, and NCDs tend to cause substantial income losses through chronic disabilities, the rising NCD-related health burden may also be economically detrimental. Given the lack of updated national-level evidence on the economic burden of NCDs in Nigeria, this study aims to produce new evidence on the extent of financial hardship experienced by households with NCDs in Nigeria due to OOP expenditure and productivity loss. This study analysed cross-sectional data from the most recent round (2018-19) of the Nigeria Living Standard Survey (NLSS). Household-level health and consumption data were used to estimate catastrophic health expenditure (CHE) and impoverishing effects due to OOP health spending, using a more equitable method recently developed by the World Health Organization European region in 2018. The productivity loss by individuals with NCDs was also estimated from income and work-time loss data, applying the input-based human capital approach. On average, a household with NCDs spent ₦ 122,313.60 or $ 398.52 per year on NCD care, representing 24% of household food expenditure. The study found that OOP on cancer treatment, mental problems, and renal diseases significantly contribute to the cost of NCD care. The OOP expenditure led to catastrophic and impoverishing outcomes for households. The estimations showed that about 30% of households with NCDs experienced CHE in 2018, using the WHO Europe method at the 40% threshold. The study also found that the cost of NCD medications was a significant driver of CHE among NCD-affected households. The results showed heterogeneity in CHE and impoverishment across states and geographical regions in Nigeria, with a higher concentration in rural and North East geopolitical locations. The study also found that 20% of NCD-affected households were impoverished or further impoverished by OOP payment, and another 10% were on the verge of impoverishment. The results showed a negligible rate of unmet needs among households with NCDs. The study highlights the significant effect of NCDs on Nigerian households and the need for effective policy interventions to address this challenge, particularly among the poor and vulnerable.

Cost of non-communicable diseases in people living with HIV in the Central Denmark Region.

To estimate the economic burden of non-communicable diseases (NCDs) in people living with HIV (PLWH) in Denmark. We conducted a cohort study using population-based Danish medical registries including all adult residents of the Central Denmark Region registered with a first-time HIV-diagnosis during the period 2006-2017. For each PLWH, we matched 10 persons without HIV from the background population by birth year, sex and municipality of residence. Information on healthcare utilization and costs for the PLWH and non-HIV cohorts was retrieved from register data. For each cohort, we estimated the annual costs for major disease categories (HIV care, other somatic care, and psychiatric care) in the period from 3 years before to 9 years after diagnosis/matching date. We identified 407 PLWH and 4070 persons from the background population. The total healthcare costs during the study period were approximately three times higher for PLWH compared to the non-HIV cohort (€76 198 vs. €23 692). Average annual cost of hospital care, primary care and selected prescription medicine was estimated to be €6987 per year in the years after the diagnosis compared to €2083 per year in the non-HIV cohort. In PLWH, the cost of NCDs and psychiatric care was approximately two times higher than the cost of HIV care. PLWH have higher healthcare costs stemming from three areas: excess cost due to the HIV infection, the treatment of NCDs, and psychiatric care.

The Case for Integrating Health Systems to Manage Noncommunicable and Infectious Diseases in Low- and Middle-Income Countries: Lessons Learned From Zambia.

Noncommunicable diseases (NCDs) are the leading cause of death in the world, and 80% of all NCD deaths occur in low- and middle-income countries (LMICs). The COVID-19 pandemic has demonstrated that patients with NCDs are at increased risk of becoming severely ill from the virus. Disproportionate investment in vertical health programs can result in health systems vulnerable to collapse when resources are strained, such as during pandemics. Although NCDs are largely preventable, globally there is underinvestment in efforts to address them. Integrating health systems to collectively address NCDs and infectious diseases through a wide range of services in a comprehensive manner reduces the economic burden of healthcare and strengthens the healthcare system. Health system resiliency is essential for health security. In this article, we provide an economically sound approach to incorporating NCDs into routine healthcare services in LMICs through improved alignment of institutions that support prevention and control of both NCDs and infectious diseases. Examples from Zambia's multisector interventions to develop and support a national NCD action plan can inform and encourage LMIC countries to invest in systems integration to reduce the social and economic burden of NCDs and infectious diseases.

Assessing the effect of developed ayurvedic food for ADHD children on animal models

As stated by World Health Organization (WHO), a cerebral disarray are to amplify by 50 per cent in the year of 2020, is the fore most finding root of morbidity in kids. The kids represent on 40 per cent in India and the rate of psychopathology amid childhood is 5 to 15 per cent (The Global Economic burden of non-communicable diseases, 2011). ADHD is a multi factorial, highly heritable disorder, estimating a mean heritability of 76 percent (Farone and Mick, 2010). The spontaneously hypertensive rat (SHR) has been used as a genetic animal model of attention deficit/hyperactivity disorder (ADHD). The open field test for loco motor activity, Y-maze test for inattention and Electro-foot shock aversive water drinking test (EFSD) for impulsivity were analyzed using one-way analysis of variance (ANOVA). However, impulsive behavior in the Ymaze tests, which is designed to detect anxiety-related behavior but also reflects impulsivity for novelty seeking, was comparable to Hyperactivity and inattention. ADHD like behaviors in SHR were ameliorated with methylphenidate at a low dose (0.05 mg/kg, i.p.). Rats were acclimated to their home cages for at least 7days before testing and all the rats were provided with commercially available normal diet. The animals were given fresh ayurvedic based health mix diet with 3 per cent, 6 per cent and 12 per cent incorporation of medhya rasayana (Centella asiatica and Bacopa monneri) daily for 100 g for each rat and leftover food was collected on next day measured and discarded. The body weights of each rat were measured every week. All the protocol and experiments were conducted in compliance with the ethical principles and guidelines provided by the committee. The experimental groups, consisting of 6 animals per drug and dose, were chosen by means of a randomized schedule and animal study has been carried out for three months. All tests took place between 9:00 am and 6.00 pm. Animal treatment and maintenance were carried out in accordance with the Principles of Laboratory Animal Care. Key words: ADHD, Bacopa monnieri, Centella asiatica, Medya rasayana, SHR.

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

BackgroundNon-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.MethodsFour 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.ResultsThe 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. ConclusionsNCDs 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.

Impact of noncommunicable diseases on direct medical costs and worker productivity, Saudi Arabia.

The prevalence of noncommunicable diseases (NCDs) has been increasing in Saudi Arabia. Our objective was to estimate the effect of NCDs on direct medical costs and workforce productivity in Saudi Arabia. To estimate direct medical costs, we estimated the unit cost of treating 10 NCDs, then multiplied the unit cost by disease prevalence and summed across diseases. To estimate workforce productivity losses, we multiplied gross domestic product per person in the labour force by the loss in productivity from each NCD and the prevalence in the labour force of each NCD. We estimated annual direct medical costs of 11.8 billion international dollars (Int$) for the 10 NCDs assessed (13.6% of total annual health expenditure). We estimated workforce productivity losses of Int$ 75.7 billion (4.5% of gross domestic product). The economic burden of NCDs in Saudi Arabia - particularly the effect on worker productivity - is substantial.

The economic burden of non-communicable diseases on households and their coping mechanisms: Evidence from rural Vietnam

In developing countries, the economic burden of non-communicable diseases (NCDs) on households may be very high, especially in rural areas where the social protection and public health care systems are inadequate and underdeveloped. However, there has been very little research on the economic burden of NCDs on households in rural areas. We used two rounds of panel data from rural Vietnam to examine the economic burden of NCDs on households and determine which coping mechanisms the affected households adopted to mitigate these burdens. We employed a difference-in-difference combined with propensity score matching method to account for selectivity bias. Our results revealed that NCDs are associated with higher numbers of labor days lost and lower earned income (particularly, income from non-farm self-employment and wage activities). We also found that the NCD-affected households resort to remittances, sales of assets, and loans in response to NCDs. In addition, households with NCDs in adults tended to experience greater economic burden and adopted more coping mechanisms than households with NCDs in the elderly or children. Our research underscores the importance of measures and policies designed to protect rural households against the economic burden of NCDs.

Impact of noncommunicable diseases on direct medical costs and worker productivity, Saudi Arabia

Background: The prevalence of noncommunicable diseases (NCDs) has been increasing in Saudi Arabia. Aim: Our objective was to estimate the effect of NCDs on direct medical costs and workforce productivity in Saudi Arabia. Methods: To estimate direct medical costs, we estimated the unit cost of treating 10 NCDs, then multiplied the unit cost by disease prevalence and summed across diseases. To estimate workforce productivity losses, we multiplied gross domestic product per person in the labour force by the loss in productivity from each NCD and the prevalence in the labour force of each NCD. Results: We estimated annual direct medical costs of 11.8 billion international dollars (Int$) for the 10 NCDs assessed (13.6% of total annual health expenditure). We estimated workforce productivity losses of Int$ 75.7 billion (4.5% of gross domestic product). Conclusion: The economic burden of NCDs in Saudi Arabia – particularly the effect on worker productivity – is substantial.

Burden of non-communicable diseases and its associated economic costs in India

Non communicable diseases (NCD) are a rising problem worldwide and is a cause of public health concern in India too. These diseases result in high health care demand and are expensive especially in low resource settings. We studied the NCD burden estimates for India and its major states and the associated cost in 2017. The disease burden was estimated using DALYs (Disability Adjusted life years), the Years of Life lost (YLL) and Years lived in disability (YLD). Health expenditure data from National Sample Survey was used to calculate out of pocket expenditure (OOPE) and catastrophic health expenditure (CHE). NCDs account for 16939 DALYs per 100 000 in India. About 50–70% of patients took treatment in private facilities. There is huge variation in the utilization of health facilities, disease burden and cost of treatment across the states. Karnataka had highest DALY rate of 25790 DALYs per 100 000 but Chandigarh showed highest mean OOPE of INR 63952 and Arunachal Pradesh showed the highest CHE of 47.7 percent. The economic burden of NCDs is notably high both in terms of OOPE and CHE and indicate variation across states in both disease burden and economic burden. The findings highlight the need for improvement of NCD management programmes in socioeconomically lower states of India.

Maternal vitamin D deficiency and GDM risk: evidence for the case of investing more attention in antenatal clinics.

Gestational diabetes mellitus (GDM) is a global public health problem, and in India, it affects about 20% of pregnancies. India, despite being a tropical country with abundant sunshine has a high prevalence (80%) of vitamin D deficiency (VDD) among reproductive-aged women. Global and Indian evidence links VDD with a higher risk of hyperglycaemia in pregnancy and GDM. VDD has also been implicated in gestational hypertension, preterm birth and poorer offspring health. Global scientific consensus acknowledges the need for maternal vitamin D screening and supplementation, but knowledge gaps exist about optimal blood levels (50-100 nmol/l), and the required vitamin D dosage (400-4000 IU). Diet can provide <10% of the vitamin D requirements, food fortification can deliver limited amounts, and hence optimal antenatal supplementation is key. Prenatal calcium supplements containing 400 IU of vitamin D may be sufficient for calcium absorption and bone health, but may not provide immunomodulatory benefits, including GDM prevention. Increasing evidence calls for higher maternal vitamin D requirements (2000-4000 IU) for skeletal, metabolic and immune health benefits. Current screening and supplementation for maternal VDD in India is low. We need to invest in future studies to determine optimal maternal vitamin D requirements and formulate policies for vitamin D supplementation to prevent GDM. Improving the maternal vitamin D status is an important nutritional priority for policymakers to reduce the large economic burden of non-communicable diseases (10% of India's gross domestic product), and eventually achieve the 2030 UN sustainable development goals.

Analyzing the Magnitude of Global Epidemiological Transition in Sub-Saharan Africa: A Need to Review the Current Healthcare Management Approach

Since after World War II, the world has been grappling with the grumbling rising prevalence and economic burden of non-communicable diseases (NCDs). The rise of these chronic diseases has reached an epidemic proportion and a melting point in many communities of the world. This has been made worse by the recent COVID-19 pandemic. While the world is still battling this debilitating reality, a more gruesome scenario is evolving in low-income and Middle-Income Countries (LMICs). Although these countries account for the highest poverty index in the world, they also account for a disproportionately higher burden of NCDs. More than 80% of NCD-related deaths are presently recorded among the LMICs. Ironically, although most sub-Saharan Africa (SSA) countries can be categorized as LMICs, yet communicable diseases (CDs) still constitute the highest disease burden in this region. However, based on global projections, SSA may soon lose this ‘advantage’ and may become the region with the highest burden of NCDs by the year 2030. If the present trajectory is left unshattered, the resulting heavy double burden of CDs and NCDs will likely crumble the already fragile economy of most SSA countries and tilt the region into an unprecedented recession. A critical review of the present disease-centered healthcare management approach and adoption of a more evidence-based health promotion-centered management approach may be vital in salvaging the situation. This article briefly reviewed the global epidemiologic transition, compared the disease- and health promotion-centered healthcare models, and made a case for a change in health management strategy in SSA. Keywords: Disease-centered approach, Epidemiological transition, Health promotion-centered approach, lifestyle modification, Non-communicable Diseases Risk factors, sub-Saharan Africa.

Sugars, Salt, Saturated Fat and Fibre Purchased through Packaged Food and Soft Drinks in Europe 2015-2018: Are We Making Progress?

The availability, purchase and consumption of foods high in fat, sugars and salt and low in fibre are linked to the high health and economic burden of noncommunicable diseases, including cancer, in Europe. Therefore, assessing the quality of the food offer is key as feedback to decision makers, as well as to identify good practices and areas of the food supply still requiring urgent action. We combined detailed market share and sales data with nutrition composition data to evaluate the nutritional quality of 14 packaged food and soft drinks categories sold across 22 European countries over the 2015–2018 period. Our analysis shows great variability of the nutritional composition within and among packaged food and soft drinks categories across European countries. Our estimates of the market-share weighted mean, a measure that integrates possible changes in nutrient content with the amount of a product sold to consumers, as well as daily per capita nutrient sale estimates, suggest a small but statistically significant progress in certain food categories only. Overall, the amounts of sugars, saturated fat, salt and fibre being sold to European citizens through these products is not improving to an extent to meet public health objectives.

Socioeconomic status and tobacco consumption: Analyzing inequalities in China, Ghana, India, Mexico, the Russian Federation and South Africa

INTRODUCTIONGlobally, there has been a rapid rise in non-communicable diseases driven by changing lifestyle choices and health behaviors. Different lifestyle choices threaten to exacerbate existing health inequalities, yet evidence monitoring the extent of this impact in emerging economies is lacking. The article sets out to measure the level of wealth-related inequality and its drivers in one of these lifestyle choices, tobacco consumption, among populations aged ≥50 years in six Low- and Middle-Income Countries.METHODSThe study provides empirical evidence of the inequality in tobacco consumption across wealth groups in China, Ghana, India, Mexico, the Russian Federation and South Africa using the Erreygers’ corrected concentration indices. These inequalities are then decomposed to gain a deeper understanding of the factors and broader social forces driving inequality. The WHO SAGE data set, collected between 2008 and 2010, is used for the analysis.RESULTSCurrent tobacco consumption is concentrated among the poor in China, Ghana, India, and South Africa, and among the wealthy in the Russian Federation and Mexico. The inequalities widen when we focus solely on the male population. Although the results differ by country, the major drivers of inequality include wealth, locality, and gender.CONCLUSIONSThe focus on tobacco consumption in this age group is key to curbing rising healthcare costs and ensuring longevity. Policies aimed at reducing wealth-related inequalities should especially target high tobacco consumption rates among males, while simultaneously pre-empting and curbing rising rates among women.

Assessing the household economic burden of non-communicable diseases in India: evidence from repeated cross-sectional surveys

BackgroundFinancing for NCDs is encumbered by out-of-pocket expenditure (OOPE) assuming catastrophic proportions. Therefore, it is imperative to investigate the extent of catastrophic health expenditure (CHE) on NCDs, which are burgeoning in India. Thus, our paper aims to examine the extent of CHE and impoverishment in India, in conjunction with socio-economic determinants impacting the CHE.MethodsWe used cross-sectional data from nationwide healthcare surveys conducted in 2014 and 2017–18. OOPE on both outpatient and inpatient treatment was coalesced to estimate CHE on NCDs. Incidence of CHE was defined as proportion of households with OOPE exceeding 10% of household expenditure. Intensity of catastrophe was ascertained by the measure of Overshoot and Mean Positive Overshoot Indices. Further, impoverishing effects of OOPE were assessed by computing Poverty Headcount Ratio and Poverty Gap Index using India’s official poverty line. Concomitantly, we estimated the inequality in incidence and intensity of catastrophic payments using Concentration Indices. Additionally, we delineated the factors associated with catastrophic expenditure using Multinomial Logistic Regression.ResultsResults indicated enormous incidence of CHE with around two-third households with NCDs facing CHE. Incidence of CHE was concentrated amongst poor that further extended from 2014(CI = − 0.027) to 2017–18(CI = − 0.065). Intensity of CHE was colossal as households spent 42.8 and 34.9% beyond threshold in 2014 and 2017-18 respectively with poor enduring greater overshoot vis-à-vis rich (CI = − 0.18 in 2014 and CI = − 0.23 in 2017–18). Significant immiserating impact of NCDs was unraveled as one-twelfth in 2014 and one-eighth households in 2017–18 with NCD burden were pushed to poverty with poverty deepening effect to the magnitude of 27.7 and 30.1% among those already below poverty on account of NCDs in 2014 and 2017–18 respectively. Further, large inter-state heterogeneities in extent of CHE and impoverishment were found and multivariate analysis indicated absence of insurance cover, visiting private providers, residing in rural areas and belonging to poorest expenditure quintile were associated with increased likelihood of incurring CHE.ConclusionSubstantial proportion of households face CHE and subsequent impoverishment due to NCD related expenses. Concerted efforts are required to augment the financial risk protection to the households, especially in regions with higher burden of NCDs.

Burden of Non-Communicable Diseases and Its Associated Economic Costs in India

Background: Non communicable diseases (NCD) are a rising problem worldwide and is a cause of public health concern in India too. These diseases result in high health care demand and are expensive especially in low resource settings. We studied the NCD burden estimates for India and its major states and the associated cost. Methods: The disease burden was estimated using DALYs (Disability Adjusted life years), the Years of Life lost (YLL) and Years lived in disability (YLD). National Sample Survey was used to calculate OOPE and CHE. Results: NCDs account for 16939 DALYs per 100,000 in India. About 50-70% of patients took treatment in private facilities. There is huge variation in the utilization of health facilities, disease burden and cost of treatment across the states. Karnataka had highest DALY rate of 25790 DALYs per 100,000 but Chandigarh showed highest mean OOPE of INR 63952 and Arunachal Pradesh showed the highest CHE of 47.7 percent. Conclusions: The economic burden of NCDs is notably high both in terms of OOPE and CHE and indicate variation across states in both diseases burden and economic burden. The findings highlight the need for improvement of NCD management programmes in socioeconomically lower states of India. Funding Information: No funds received for this research. Declaration of Interests: None declared.

The impact of seven major noncommunicable diseases on direct medical costs, absenteeism, and presenteeism in Gulf Cooperation Council countries

Aims To estimate the current burden of seven major noncommunicable diseases on direct medical costs, absenteeism, and presenteeism in the six countries in the Gulf Cooperation Council: Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates. Materials and methods We used data from pre-existing datasets and the literature. We identified seven major noncommunicable diseases for which data were available: coronary heart disease, stroke, type-2 diabetes mellitus, breast cancer, colon cancer, chronic obstructive pulmonary disease, and asthma. We estimated the per unit cost (the annual cost of treating each illness for one person) of each disease, multiplied per unit cost by disease prevalence counts to generate disease-specific costs, and then summed across diseases. We calculated the cost of absenteeism and presenteeism by multiplying the gross domestic product per person in the labor force by the loss in productivity from each disease due to absenteeism and presenteeism, respectively, and the prevalence in the labor force of each disease. Results We estimate that the direct medical costs of seven major noncommunicable diseases in Gulf Cooperation Council countries are $16.7 billion (2019 International $), equal to 0.6% of gross domestic product. We estimate that absenteeism and presenteeism due to these seven noncommunicable diseases cost 0.5 and 2.2% of gross domestic product, respectively. Limitations Our study does not capture all noncommunicable diseases and does not capture all types of indirect costs. Our cost estimates are particularly sensitive to our assumptions regarding type-2 diabetes mellitus. Conclusion The economic burden of noncommunicable diseases in Gulf Cooperation Council countries is substantial, suggesting that successful preventive interventions have the potential to improve both population health and reduce costs. Further research is needed to capture a broader array of noncommunicable diseases and to develop more precise estimates.

Assessing the future medical cost burden for the European health systems under alternative exposure-to-risks scenarios.

BackgroundAgeing populations and rising prevalence of non-communicable diseases (NCDs) increasingly contribute to the growing cost burden facing European healthcare systems. Few studies have attempted to quantify the future magnitude of this burden at the European level, and none of them consider the impact of potential changes in risk factor trajectories on future health expenditures.MethodsThe new microsimulation model forecasts the impact of behavioural and metabolic risk factors on NCDs, longevity and direct healthcare costs, and shows how changes in epidemiological trends can modify those impacts. Economic burden of NCDs is modelled under three scenarios based on assumed future risk factors trends: business as usual (BAU); best case and worst case predictions (BCP and WCP).FindingsThe direct costs of NCDs in the EU 27 countries and the UK (in constant 2014 prices) will grow under all scenarios. Between 2014 and 2050, the overall healthcare spending is expected to increase by 0.8% annually under BAU. In the all the countries, 605 billion Euros can be saved by 2050 if BCP is realized compared to the BAU, while excess spending under the WCP is forecast to be around 350 billion. Interpretation: Although the savings realised under the BCP can be substantial, population ageing is a stronger driver of rising total healthcare expenditures in Europe compared to scenario-based changes in risk factor prevalence.