A systematic review of the economic burden of diabetes mellitus: contrasting perspectives from high and low middle-income countries

ABSTRACT

Introduction

Diabetes increases preventative sickness and costs healthcare and productivity. Type 2 diabetes and macrovascular disease consequences cause most diabetes-related costs. Type 2 diabetes greatly costs healthcare institutions, reducing economic productivity and efficiency. This cost of illness (COI) analysis examines the direct and indirect costs of treating and managing type 1 and type 2 diabetes mellitus.

Methodology

According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, Cochrane, PubMed, Embase, CINAHL, Scopus, Medline Plus, and CENTRAL were searched for relevant articles on type 1 and type 2 diabetes illness costs. The inquiry returned 873 2011–2023 academic articles. The study included 42 papers after an abstract evaluation of 547 papers.

Results

Most articles originated in Asia and Europe, primarily on type 2 diabetes. The annual cost per patient ranged from USD87 to USD9,581. Prevalence-based cost estimates ranged from less than USD470 to more than USD3475, whereas annual pharmaceutical prices ranged from USD40 to more than USD450, with insulin exhibiting the greatest disparity. Care for complications was generally costly, although costs varied significantly by country and problem type.

Discussion

This study revealed substantial heterogeneity in diabetes treatment costs; some could be reduced by improving data collection, analysis, and reporting procedures. Diabetes is an expensive disease to treat in low- and middle-income countries, and attaining Universal Health Coverage should be a priority for the global health community.

KEYWORDS:

• Cost-of-illness
• diabetes
• cost analysis
• cost of disease
• economic burden
• healthcare costs

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethical approval

The study was approved by the Ethical Committee of Universiti Sains Malaysia (USM/JEPeM/22090589). The Bio-Ethics Committee (BEC) of Bahauddin Zakariya University, Multan, also permitted (ACAD/EXT/01/2022).

Consent to participate

All participants signed their informed consent before starting a participant interview.

Availability of data

The data sets used and analysed during the current study are available from the corresponding author at a reasonable request.

Code availability

The collected data were analysed using statistical tools in SPSS version 22.0 data analysing software.

Authors’ contribution

Conceptualization: Siew Chin Ong, Muhammad Daoud Butt, Data curation: Muhammad Nasir Kalam, Muhammad Abdullah, Azra Rafiq, Tooba Malik Formal analysis: Ahsan Sajjad, Muhammad Nasir Kalam Investigation: Muhammad Abdullah, Ahsan Sajjad, Fatima Yaseen, and Tooba Malik Methodology: Muhammad Daoud Butt, Azra Rafiq, Siew Chin Ong, and Zaheer-Ud-Din Babar Project administration: Muhammad Daoud Butt, Muhammad Nasir Kalam Resources: Muhammad Daoud Butt, Muhammad Nasir Kalam Supervision: Siew Chin Ong, Zaheer-Ud-Din Babar Validation: Muhammad Abdullah, Azra Rafiq, Ahsan Sajjad, Tooba Malik, and Fatima Yaseen Visualization: Muhammad Daoud Butt Writing—original draft: Muhammad Daoud Butt, Tooba Malik, Fatima Yaseen, and Ahsan Sajjad Writing – Review & editing: Muhammad Daoud Butt, Siew Chin Ong, Fatima Yaseen, and Zaheer-Ud-Din Babar. All authors have read and agreed to the published version of the manuscript.