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

Figures & data

Table 1. Estimated mortality, prevalence, and annual per unit cost of NCDs in GCC countries, 2019.

	Coronary heart disease^b	Stroke^b	Type 2 diabetes mellitus^b	Breast cancer^b	Colon cancer^b	COPD^c	Asthma^d
Estimated mortality rate (deaths per 100,000 population)^a
Bahrain	59.8	17.0	48.5	7.2	5.8	7.7	2.2
Kuwait	58.7	20.8	8.0	3.9	5.0	3.4	0.7
Oman	74.4	22.5	14.0	2.9	2.9	4.4	0.2
Qatar	29.0	6.3	11.7	3.1	2.9	.7	0.3
Saudi Arabia	83.1	35.5	7.8	4.0	4.6	5.9	2.5
UAE	52.8	23.5	13.3	4.9	4.9	11.8	6.0
Estimated prevalence^a
Bahrain (%)	3.5	1.0	13.3	0.2	0.1	1.4	3.3
Kuwait (%)	3.2	1.0	8.9	0.2	0.1	0.9	4.1
Oman (%)	2.1	0.9	4.4	0.1	0.0	0.8	3.9
Qatar (%)	1.7	0.8	10.0	0.1	0.0	1.0	3.1
Saudi Arabia (%)	2.4	1.4	7.2	0.1	0.1	1.3	2.5
UAE (%)	2.2	1.5	8.0	0.1	0.0	2.1	6.8
Estimated per unit annual direct medical cost (2019 International $)
Bahrain	1,264	3,077	2,644	1,176	3,504	2,648	359
Kuwait	1,496	3,640	3,239	1,391	4,145	3,306	448
Oman	130	316	271	121	359	272	37
Qatar	1,648	4,013	3,071	1,534	4,569	3,015	409
Saudi Arabia	958	2,331	1,936	891	2,655	3,056	414
UAE	1,406	3,422	3,456	1,308	3,898	2,772	376

Abbreviations. NCD, noncommunicable disease; UAE, United Arab Emirates; COPD, chronic obstructive pulmonary disease; estimates may not sum to totals due to rounding.

^aIHME 2020⁸.

^bKuwait, Qatar, Saudi Arabia, and UAE estimates are from Ding, Lawson, Kolbe-Alexander et al. 2016⁹; Bahrain and Oman estimates are imputed based on the median per capita cost estimate in Kuwait, Qatar, Saudi Arabia, and UAE.

^cCOPD estimates are based on Wacker, Jörres, Schulz et al. (2016)¹⁰.

^dAsthma estimates are based on Alzaabi, Alseiari, Mahboub (2014)⁷.

Table 2. Estimated annual direct medical costs due to NCDs in GCC countries.

	Estimated annual direct medical costs (millions of 2019 Int $)
	Coronary heart disease	Stroke	Type 2 diabetes mellitus	Breast cancer	Colon cancer	COPD	Asthma	Total
Bahrain	73	53	578	4	3	63	19	794
Kuwait	204	156	1,218	9	10	129	78	1,806
Oman	13	13	59	1	1	10	7	104
Qatar	79	93	871	6	5	82	36	1,172
Saudi Arabia	798	1,118	4,796	43	45	1,320	352	8,472
UAE	302	508	2,701	15	15	577	251	4,371
Total	1,469	1,942	10,224	78	80	2,181	744	16,719

Abbreviations. NCD, noncommunicable disease; UAE, United Arab Emirates; COPD, chronic obstructive pulmonary disease; estimates may not sum to totals due to rounding.

Table 3. Estimated total direct medical costs vis-à-vis GDP in GCC countries.

	Total direct medical costs (millions of 2019 International $)	Total direct medical costs as a%age of GDP (%)
Bahrain	794	1.0
Kuwait	1,806	0.8
Oman	104	0.4
Qatar	1,172	0.4
Saudi Arabia	8,472	0.5
UAE	4,371	0.6
GCC	16,719	0.6

Abbreviations. NCD, noncommunicable disease; UAE, United Arab Emirates; GCC, Gulf Cooperation Council.

Table 4. Estimated absenteeism, presenteeism, and productivity costs Due to NCDs in GCC countries.

	Coronary heart disease	Stroke	Type 2 diabetes	Breast cancer	Colon cancer	COPD	Asthma	Total
Estimated annual absenteeism costs (millions of 2019 Int $)
Bahrain	94	27	101	15	4	82	107	430
Kuwait	253	78	199	32	12	154	341	1,068
Oman	109	43	65	18	4	84	217	534
Qatar	150	72	254	29	9	182	333	1,027
Saudi Arabia	1,518	855	1,290	219	78	1,688	1,857	7,505
UAE	493	338	513	67	22	1,032	2,284	4,749
Total	2,616	1,413	2,422	372	129	3,223	5,140	15,314
Estimated annual presenteeism costs (millions of 2019 Int $)
Bahrain	227	66	1,438	18	5	232	236	2,223
Kuwait	614	190	2,838	38	14	435	751	4,879
Oman	265	106	928	14	5	237	478	2,033
Qatar	363	174	3,613	35	11	513	732	5,441
Saudi Arabia	3,686	2,077	18,386	265	95	4,761	4,085	33,354
UAE	1,198	820	7,303	82	27	2,910	5,025	17,365
Total	6,353	3,432	34,506	452	156	9,087	11,307	65,295
Estimated annual productivity losses (millions of 2019 Int $)
Bahrain	321	93	1,540	32	9	314	344	2,653
Kuwait	866	268	3,037	69	26	589	1,092	5,947
Oman	374	149	993	26	9	321	696	2,567
Qatar	513	245	3,866	64	20	696	1,064	6,468
Saudi Arabia	5,204	2,932	19,676	484	173	6,449	5,942	40,859
UAE	1,691	1,158	7,816	149	50	3,942	7,309	22,115
Total	8,969	4,846	36,928	824	285	12,310	16,447	80,609

Abbreviations. NCD, noncommunicable disease; UAE, United Arab Emirates; COPD, chronic obstructive pulmonary disease; productivity losses, absenteeism costs + presenteeism costs; estimates may not sum to totals due to rounding.

Table 5. Estimated absenteeism, presenteeism, and productivity costs vis-à-vis GDP in GCC countries.

	Total costs (millions of 2019 international $)			Total costs as a % of GDP
	Absenteeism	Presenteeism	Productivity	Absenteeism (%)	Presenteeism (%)	Productivity (%)
Bahrain	430	2,223	2,653	0.6	2.9	3.4
Kuwait	1,068	4,879	5,947	0.5	2.2	2.7
Oman	534	2,033	2,567	1.8	6.9	8.7
Qatar	1,027	5,441	6,468	0.4	2.0	2.4
Saudi Arabia	7,504	33,354	40,859	0.4	2.0	2.4
UAE	4,749	17,365	22,115	0.7	2.5	3.2
GCC	15,314	65,295	80,609	0.5	2.2	2.7

Abbreviations. UAE, United Arab Emirates; GCC, Gulf Cooperation Council. Sums may not add to totals due to rounding.

Table 6. Sensitivity analyses.

	Direct medical costs		Absenteeism costs		Presenteeism costs		Productivity costs
	Int $	% of GDP	Int $	% of GDP	Int $	% of GDP	Int $	% of GDP
Base case	16.7	0.6	15.3	0.5	65.3	2.2	80.6	2.7
Higher diabetes per unit cost^a	43.3	1.5	15.3*	0.5*	65.3*	2.2*	80.6*	2.7*
Lower diabetes per unit cost^b	13.0	0.4	15.3*	0.5*	65.3*	2.2*	80.6*	2.7*
Higher COPD per unit cost^c	18.3	0.6	15.3*	0.5*	65.3*	2.2*	80.6*	2.7*
Lower COPD per unit cost^d	15.3	0.5	15.3*	0.5*	65.3*	2.2*	80.6*	2.7*
Higher diabetes prevalence^e	22.9	0.8	16.8	0.6	86.1	2.9	102.9	3.5
Alternative assumptions about the impact of stroke and type 2 diabetes mellitus on absenteeism and presenteeism	16.7*	0.6*	15.6	0.5	30.7	1.0	46.3	1.6

All figures refer to the Gulf Cooperation Council countries in the aggregate; Int $, billions of international dollars; an asterisk (*) indicates no change from the base case; productivity loss absenteeism costs + presenteeism costs; absenteeism and presenteeism costs may not sum to productivity loss due to rounding.

^aMokdad, Tuffaha, Hanlon et al. (2015)¹⁶.

^bAlmutairi and Alkharfy (2013)¹⁷.

^cDalal, Christensen, Liu, Riedel (2010)¹².

^dSouliotis, Kousoulakou, Hillas et al. (2017)¹¹.

^eInternational Diabetes Foundation (2019)¹⁸.

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