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Costing of diabetes mellitus type II in Cambodia.

Flessa S, Zembok A - Health Econ Rev (2014)

Bottom Line: However, an increased availability of Oral Anti-Diabetic and Insulin Therapy is highly cost-effective.The simulations clearly indicate that prevention and treatment of this disease is highly cost-effective.However, not everything that is cost-effective might be affordable in Cambodia.

View Article: PubMed Central - PubMed

Affiliation: Department of Health Care Management, University of Greifswald, Friedrich-Loeffler-Straße 70, Greifswald, 17487, Germany, steffen.flessa@uni-greifswald.de.

ABSTRACT

Background: Diabetes Mellitus Type II (T2DM) is a major and growing medical, social and economic burden in the East-Asian country of Cambodia. However, no economic modelling has been done to predict the number of cases and the budget impact.

Objective: This paper forecasts the epidemiological and economic consequences of T2DM in Cambodia. The Ministry of Health and related donor agencies are supported to select the most cost-effective interventions against the disease. At the same time this paper demonstrates the relevance and potential of health economic modelling for least developed countries.

Methods: We developed a Markov-Model for the specific situation of Cambodia. Data was taken from the scientific literature, grey literature in Cambodia and key-informant interviews.

Results: The number of people living with T2DM is steadily increasing from 145,000 in the year 2008 to 264,000 in the year 2028 (+82 %). In the year 2008 the diagnosed T2DM patients would incur costs of some 2 million US$ to cover all of diabetes treatment. 57 % of this amount would have to be spent for OAD-therapy, the rest for insulin therapy. In the year 2028 this amount will have grown to some 4 million US$. If all patients (incl. non-diagnosed) had to be paid-for the respective figure would be 5.5 million and 11 million US$. Screening for T2DM is only cost-effective if the sensitivity of the test is high while the unit price is low. The results of this simulation call for targeting the high-risk groups. However, an increased availability of Oral Anti-Diabetic and Insulin Therapy is highly cost-effective.

Discussion: Type 2 Diabetes Mellitus is a major public health challenge in Cambodia. The simulations clearly indicate that prevention and treatment of this disease is highly cost-effective. However, not everything that is cost-effective might be affordable in Cambodia. This country will require external support to ease the growing burden of T2DM.

No MeSH data available.


Related in: MedlinePlus

Cost-effectiveness area of screening.
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Fig5: Cost-effectiveness area of screening.

Mentions: If we focus on risk groups and reduce the coverage of the population the cost per screening could be higher. Every combination of coverage (x-axis) and cost (y-axis) to the lower-left of the curves of Figure 5 is cost-effective. If we limit, for instance, screening to 33% of the adult population ≥ 35 yrs. the cost per screening could rise to 3.18 US$ (sensitivity 100%), 1.93 US$ (sensitivity 75%) and 0.69 US$ (sensitivity 50%). For instance, limiting screening to the obese allows even higher unit costs while still safeguarding cost-effectiveness of the intervention. In the discussion we will address this issue again.Figure 5


Costing of diabetes mellitus type II in Cambodia.

Flessa S, Zembok A - Health Econ Rev (2014)

Cost-effectiveness area of screening.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4502066&req=5

Fig5: Cost-effectiveness area of screening.
Mentions: If we focus on risk groups and reduce the coverage of the population the cost per screening could be higher. Every combination of coverage (x-axis) and cost (y-axis) to the lower-left of the curves of Figure 5 is cost-effective. If we limit, for instance, screening to 33% of the adult population ≥ 35 yrs. the cost per screening could rise to 3.18 US$ (sensitivity 100%), 1.93 US$ (sensitivity 75%) and 0.69 US$ (sensitivity 50%). For instance, limiting screening to the obese allows even higher unit costs while still safeguarding cost-effectiveness of the intervention. In the discussion we will address this issue again.Figure 5

Bottom Line: However, an increased availability of Oral Anti-Diabetic and Insulin Therapy is highly cost-effective.The simulations clearly indicate that prevention and treatment of this disease is highly cost-effective.However, not everything that is cost-effective might be affordable in Cambodia.

View Article: PubMed Central - PubMed

Affiliation: Department of Health Care Management, University of Greifswald, Friedrich-Loeffler-Straße 70, Greifswald, 17487, Germany, steffen.flessa@uni-greifswald.de.

ABSTRACT

Background: Diabetes Mellitus Type II (T2DM) is a major and growing medical, social and economic burden in the East-Asian country of Cambodia. However, no economic modelling has been done to predict the number of cases and the budget impact.

Objective: This paper forecasts the epidemiological and economic consequences of T2DM in Cambodia. The Ministry of Health and related donor agencies are supported to select the most cost-effective interventions against the disease. At the same time this paper demonstrates the relevance and potential of health economic modelling for least developed countries.

Methods: We developed a Markov-Model for the specific situation of Cambodia. Data was taken from the scientific literature, grey literature in Cambodia and key-informant interviews.

Results: The number of people living with T2DM is steadily increasing from 145,000 in the year 2008 to 264,000 in the year 2028 (+82 %). In the year 2008 the diagnosed T2DM patients would incur costs of some 2 million US$ to cover all of diabetes treatment. 57 % of this amount would have to be spent for OAD-therapy, the rest for insulin therapy. In the year 2028 this amount will have grown to some 4 million US$. If all patients (incl. non-diagnosed) had to be paid-for the respective figure would be 5.5 million and 11 million US$. Screening for T2DM is only cost-effective if the sensitivity of the test is high while the unit price is low. The results of this simulation call for targeting the high-risk groups. However, an increased availability of Oral Anti-Diabetic and Insulin Therapy is highly cost-effective.

Discussion: Type 2 Diabetes Mellitus is a major public health challenge in Cambodia. The simulations clearly indicate that prevention and treatment of this disease is highly cost-effective. However, not everything that is cost-effective might be affordable in Cambodia. This country will require external support to ease the growing burden of T2DM.

No MeSH data available.


Related in: MedlinePlus