From the Guidelines
To analyze the economic burden of non-communicable diseases (NCDs), implement a comprehensive approach that combines direct healthcare costs, indirect productivity losses, and intangible costs, as recommended by the most recent and highest quality study 1.
Key Components of Analysis
- Collect data on direct medical expenses including hospitalization, outpatient care, medications, diagnostic tests, and long-term care for conditions like diabetes, cardiovascular disease, cancer, and chronic respiratory diseases.
- Calculate indirect costs by measuring productivity losses from premature mortality, absenteeism, presenteeism, and early retirement, using methods like the human capital approach or friction cost method.
- Quantify intangible costs such as pain, suffering, and reduced quality of life using quality-adjusted life years (QALYs) or disability-adjusted life years (DALYs).
Importance of Comprehensive Approach
The economic burden of NCDs is substantial, with costs often extending decades beyond diagnosis, as noted in 1 and 1. Understanding these economic dimensions helps policymakers allocate resources effectively and design cost-effective prevention and management strategies that can reduce the long-term financial impact of these chronic conditions.
Recent Estimates
A recent study estimated the overall economic costs of heart failure in 2012 to be $108 billion, with direct costs accounting for about 60% ($65 billion) and indirect costs for about 40% ($43 billion) 1. Another study estimated the economic costs of cardiovascular disease, cancer, and diabetes in the United States in 2003 to be $351.8 billion, $189.5 billion, and $132.0 billion, respectively 1.
Societal Perspective
It is essential to take a societal perspective when analyzing the economic burden of NCDs, as recommended by 1, to estimate the total impact on society, including the health sector, non-health sector, and households. This approach helps to make the economic case for additional healthcare resources and informs cross-sectoral partnership and policy development.
From the Research
Analyzing the Economic Burden of Non-Communicable Diseases
To analyze the economic burden of non-communicable diseases (NCDs), several factors must be considered, including direct and indirect costs, healthcare expenditure, and national income.
- Direct costs include healthcare-related expenses, such as hospitalization, medication, and medical procedures 2, 3.
- Indirect costs, on the other hand, refer to economic losses due to reduced productivity, absenteeism, and premature mortality 3, 4.
Assessing the Economic Burden
Studies have shown that NCDs impose a significant economic burden on individuals, families, and societies.
- A systematic review of the financial burden of NCDs in the European Union found that the four major NCDs (cardiovascular disease, cancer, type-2 diabetes mellitus, and chronic respiratory disease) claim at least 25% of the total health care budget and impose an important economic loss of almost 2% of gross domestic product 2.
- Another study found that NCDs pose a significant financial burden on healthcare budgets and nations' welfare, with healthcare expenditure for cardiovascular disease being the highest, ranging from 12-16.5% 3.
Household Economic Burden
The household economic burden of NCDs is also significant, particularly in low- and middle-income countries.
- A study found that the prevalence of catastrophic spending and impoverishment is highest among households with NCDs in lower middle-income countries and China 4.
- The study also found that a high proportion of those with NCDs in low-income countries reported not taking medication due to costs, which may mask the true burden of NCD care in these countries.
Socio-Economic Burden
The socio-economic burden of NCDs is not limited to direct and indirect costs.
- A systematic review of the cost of illness evidence for rare diseases found that most of the rare diseases examined are associated with significant economic burden, both direct and indirect 5.
- Another study found that the economic effect of preventive measures for non-communicable diseases is clearly demonstrated, and that the effectiveness of the health care system and individual treatment and prevention institutions should be considered in a complex way from the point of view of medical, social, and economic efficiency 6.
Key Considerations
When analyzing the economic burden of NCDs, several key considerations must be taken into account, including:
- The need for cost analyses of NCDs, particularly on the impact of comorbidities and other complications 2.
- The importance of standardizing methods for assessing the economic impact of NCDs 3.
- The need for further research on the economic burden of NCDs in low- and middle-income countries 4.
- The significance of indirect costs, such as reduced productivity and premature mortality, in estimating the economic burden of NCDs 3, 4.