Direct and indirect cost of diabetes care among patients with type 2 diabetes in private clinics: a multicenter study in Punjab, Pakistan

ABSTRACT

Background: Diabetes mellitus (DM) has a very high prevalence and poses a huge financial encumbrance on patients. This study aimed to evaluate the cost of diabetes care among patients with type 2 diabetes in private clinics of southern Punjab, Pakistan.

Research design and methods: This was a descriptive, cross-sectional, prevalence-based, cost-of-illness (COI) study conducted in six private clinics of southern Punjab from July to September 2016, using a pretested questionnaire. Study participants were recruited using a random selection method. Continuous variables, including direct and indirect costs, were summarized using descriptive statistics. Inferential statistics were also used to analyze the correlation between the variables and cost.

Results: The mean annual direct cost per patient with diabetes was estimated to be 332 USD. Medications accounted for the largest share (60.4%) of this cost. Age, locality, high socioeconomic status, and prolonged disease duration were significantly associated with the direct costs of illness (p < 0.05). Moreover, 19% of total earnings among very low-income patients were spent on diabetes care.

Conclusions: A substantial proportion of patients’ income is spent on diabetes care in Punjab. Our findings support the substantial individual and societal burden caused by diabetes.

KEYWORDS:

• Diabetes mellitus
• direct cost on diabetes
• indirect cost
• Pakistan

Acknowledgments

We thank Analisa Avila, ELS, of Liwen Bianji, Edanz Group China (www.liwenbianji.cn/ac), for editing the English text of a draft of this manuscript.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Authors’ contributions

Ali Hassan Gillani designed the study protocols and questionnaires. Ali Hassan Gillani Muhammad Majid Aziz, Anum Saqib, and Imran Masood conducted the survey and drafted the manuscript. Jie chang and Caijun Yang help to analyze the data. Yu Fang and Mohamed Izham Mohamed Ibrahim revised the manuscript. Yu Fang supervised the whole study.

Additional information

Funding

This work was supported by the ‘Young Talent Support Program’ and ‘High Achiever Plan’ of Health Science Center,Xi'an Jiaotong University, Central University Basic Research Fund (2015qngz05) and the China Medical Board grant [14-196, 16-262].