Estimating the Economic Burden of Diabetes Mellitus in Kenya: a Cost of Illness Study
Keywords:
Economic evaluation, income, health spending, inpatient
Abstract
Diabetes mellitus is one of the non-communicable diseases that depletes the wealth of any individual directly and indirectly due to the cost associated with treating the illness and its complications. The study aims to estimate the economic burden of Diabetes mellitus in Kenya from a societal perspective using a cost-of-illness approach. The study’s results and findings for the economic burden of diabetes mellitus in Kenya relied on the cost of illness approach. The approach identifies and measures all the costs of Diabetes mellitus, including direct and indirect costs. The 552,400 adult cases reported in 2019 resulted in a total economic cost of USD 372,184,585, equivalent to USD 674 per diabetes mellitus patient. The total direct costs accounted for the highest proportion of the overall costs at 61% (USD 227,980,126), whereas indirect costs accounted for 39% of the total economic costs (USD 144,204,459). Costs of medicines accounted for the highest costs over the total economic costs at about 29%, followed by the income lost while seeking care at 19.7%. Other costs that accounted for more than 10% of the total costs include productivity losses (19%), diagnostic tests (13%), and travel (12%). The rest of the cost categories accounted for less than 5%. Efforts should be made to reduce the costs of these medicines to enhance care. The high indirect costs reported, majorly in income lost by patients while seeking medical care, are 19%. Access to affordable health services such as diabetes mellitus education, regular blood glucose screening initiatives, and increasing local manufacturing of medicines can reduce the economic burden of diabetes mellitus and increase the health outcomes of the population and their contributions to society.
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References
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20. Matheka, D. M., Kilonzo, J. M., Munguti, C. M., & Mwangi, P. W. (2013). Pattern, knowledge and practices of HbA1C testing among diabetic patients in a Kenyan tertiary referral hospital. Globalization and Health, 9(1). https://doi.org/10.1186/1744-8603-9-55
21. Michael F. Drummond, Mark J. Sculpher, Karl Claxton, Greg L. Stoddart, G. W. T. (2015). Methods for the Economic Evaluation of Health Care Programmes. https://global.oup.com/academic/product/methods-for-the-economic-evaluation-of-health-care-programmes-9780199665884?cc=ke&lang=en&
22. Mohajan, H. (2013). Poverty and economic development of Kenya. International Journal of Information Technology and Business Management, 18(1).
23. Murray, C. J. L., & Lopez, Alan D, . (1996). The Global burden of disease : a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020,. In Harvard School of Public Health,.
24. Oyando, R., Njoroge, M., Nguhiu, P., Sigilai, A., Kirui, F., Mbui, J., Bukania, Z., Obala, A., Munge, K., Etyang, A., & Barasa, E. (2020a). Patient costs of diabetes mellitus care in public health care facilities in Kenya. International Journal of Health Planning and Management, 35(1). https://doi.org/10.1002/hpm.2905
25. Oyando, R., Njoroge, M., Nguhiu, P., Sigilai, A., Kirui, F., Mbui, J., Bukania, Z., Obala, A., Munge, K., Etyang, A., & Barasa, E. (2020b). Patient costs of diabetes mellitus care in public health care facilities in Kenya. International Journal of Health Planning and Management, 35(1), 290–308. https://doi.org/10.1002/hpm.2905
26. Park, P. H., & Pastakia, S. D. (2018). Access to Hemoglobin A1c in Rural Africa: A Difficult Reality with Severe Consequences. In Journal of Diabetes Research (Vol. 2018). https://doi.org/10.1155/2018/6093595
27. Peters, M. L., Huisman, E. L., Schoonen, M., & Wolffenbuttel, B. H. R. (2017). The current total economic burden of diabetes mellitus in the Netherlands. Netherlands Journal of Medicine, 75(7).
28. Preis, S. R., Hwang, S. J., Coady, S., Pencina, M. J., D’Agostino, R. B., Savage, P. J., Levy, D., & Fox, C. S. (2009). Trends in all-cause and cardiovascular disease mortality among women and men with and without diabetes mellitus in the framingham heart study, 1950 to 2005. Circulation, 119(13). https://doi.org/10.1161/CIRCULATIONAHA.108.829176
Saeedi, P., Petersohn, I., Salpea, P., Malanda, B., Karuranga, S., Unwin, N., Colagiuri, S., Guariguata, L., Motala, A. A., Ogurtsova, K., Shaw, J. E., Bright, D., & Williams, R. (2019). Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Research and Clinical Practice, 157.
2. Ahmed, A. A., & Almulla, N. N. (2020). Economic burden of diabetes care: The economic burden on health systems of low and middle-income African countries. WORLD FAMILY MEDICINE, 18(12).
3. Athanasakis, K., Kyriopoulos, I. I., Sideris, M., Rentzos, M., Evdokimidis, J., & Kyriopoulos, J. (2015). Investigating the economic burden of ALS in Greece: A cost-of-illness approach. Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 16(1–2). https://doi.org/10.3109/21678421.2014.932384
4. Atun, R., Davies, J. I., Gale, E. A. M., Bärnighausen, T., Beran, D., Kengne, A. P., Levitt, N. S., Mangugu, F. W., Nyirenda, M. J., Ogle, G. D., Ramaiya, K., Sewankambo, N. K., Sobngwi, E., Tesfaye, S., Yudkin, J. S., Basu, S., Bommer, C., Heesemann, E., Manne-Goehler, J., … Werfalli, M. (2017). Diabetes in sub-Saharan Africa: from clinical care to health policy. In The Lancet Diabetes and Endocrinology (Vol. 5, Issue 8). https://doi.org/10.1016/S2213-8587(17)30181-X
5. Bahia, L. R., da Rosa, M. Q. M., Araujo, D. V., Correia, M. G., dos Rosa, R. D. S., Duncan, B. B., & Toscano, C. M. (2019). Economic burden of diabetes in Brazil in 2014. Diabetology and Metabolic Syndrome, 11(1). https://doi.org/10.1186/s13098-019-0448-4
6. Bahia, L. R., Da Rosa, M. Q. M., Araujo, D. V., Correia, M. G., Dos Rosa, R. D. S., Duncan, B. B., & Toscano, C. M. (2019). Economic burden of diabetes in Brazil in 2014. Diabetology and Metabolic Syndrome, 11(1), 54. https://doi.org/10.1186/s13098-019-0448-4
7. Barasa, E. W., Maina, T., & Ravishankar, N. (2017). Assessing the impoverishing effects, and factors associated with the incidence of catastrophic health care payments in Kenya. International Journal for Equity in Health, 16(1). https://doi.org/10.1186/s12939-017-0526-x
8. Barceló, A., Aedo, C., Rajpathak, S., & Robles, S. (2003). The cost of diabetes in Latin America and the Caribbean. Bulletin of the World Health Organization, 81(1).
9. Brown, E., Natoli, N., McLaughlin, R., & Mehta, K. (2015). Pathways and Barriers to Diabetes Screening: Observations from Rural Kenya. Procedia Engineering, 107. https://doi.org/10.1016/j.proeng.2015.06.096
10. Chuma, J., & Maina, T. (2012). Catastrophic health care spending and impoverishment in Kenya. BMC Health Services Research, 12. https://doi.org/10.1186/1472-6963-12-413
11. Comino, E. J., Harris, M. F., Islam, M. D. F., Tran, D. T., Jalaludin, B., Jorm, L., Flack, J., & Haas, M. (2015). Impact of diabetes on hospital admission and length of stay among a general population aged 45 year or more: A record linkage study. BMC Health Services Research, 15(1). https://doi.org/10.1186/s12913-014-0666-2
12. De Lagasnerie, G., Aguadé, A. S., Denis, P., Fagot-Campagna, A., & Gastaldi-Menager, C. (2018). The economic burden of diabetes to French national health insurance: a new cost-of-illness method based on a combined medicalized and incremental approach. European Journal of Health Economics, 19(2). https://doi.org/10.1007/s10198-017-0873-y
13. Drummond, M. F., O’Brien, B., Stoddart, G. L., & Torrance, G. W. (1998). Methods for the Economic Evaluation of Health Care Programmes, Second Edition. In American Journal of Preventive Medicine (Vol. 14, Issue 3). https://doi.org/10.1016/S0749-3797(97)00069-X
14. Jo, C. (2014). Cost-of-illness studies: concepts, scopes, and methods. In Clinical and molecular hepatology (Vol. 20, Issue 4, pp. 327–337). Korean Association for the Study of the Liver. https://doi.org/10.3350/cmh.2014.20.4.327
15. Kirigia, J. M., Sambo, H. B., Sambo, L. G., & Barry, S. P. (2009a). Economic burden of diabetes mellitus in the WHO African region. BMC International Health and Human Rights, 9(1). https://doi.org/10.1186/1472-698X-9-6
16. Kirigia, J. M., Sambo, H. B., Sambo, L. G., & Barry, S. P. (2009b). Economic burden of diabetes mellitus in the WHO African region. BMC International Health and Human Rights, 9(1), 1–12. https://doi.org/10.1186/1472-698X-9-6
17. KNBS. (2020). Economic Survey 2020. In Economic Survey 2020.
18. Krensel, M., Schäfer, I., & Augustin, M. (2019). Cost-of-illness of melanoma in Europe – a modelling approach. Journal of the European Academy of Dermatology and Venereology, 33. https://doi.org/10.1111/jdv.15308
19. Mapa-Tassou, C., Katte, J. C., Mba Maadjhou, C., & Mbanya, J. C. (2019). Economic Impact of Diabetes in Africa. In Current Diabetes Reports (Vol. 19, Issue 2). https://doi.org/10.1007/s11892-019-1124-7
20. Matheka, D. M., Kilonzo, J. M., Munguti, C. M., & Mwangi, P. W. (2013). Pattern, knowledge and practices of HbA1C testing among diabetic patients in a Kenyan tertiary referral hospital. Globalization and Health, 9(1). https://doi.org/10.1186/1744-8603-9-55
21. Michael F. Drummond, Mark J. Sculpher, Karl Claxton, Greg L. Stoddart, G. W. T. (2015). Methods for the Economic Evaluation of Health Care Programmes. https://global.oup.com/academic/product/methods-for-the-economic-evaluation-of-health-care-programmes-9780199665884?cc=ke&lang=en&
22. Mohajan, H. (2013). Poverty and economic development of Kenya. International Journal of Information Technology and Business Management, 18(1).
23. Murray, C. J. L., & Lopez, Alan D, . (1996). The Global burden of disease : a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020,. In Harvard School of Public Health,.
24. Oyando, R., Njoroge, M., Nguhiu, P., Sigilai, A., Kirui, F., Mbui, J., Bukania, Z., Obala, A., Munge, K., Etyang, A., & Barasa, E. (2020a). Patient costs of diabetes mellitus care in public health care facilities in Kenya. International Journal of Health Planning and Management, 35(1). https://doi.org/10.1002/hpm.2905
25. Oyando, R., Njoroge, M., Nguhiu, P., Sigilai, A., Kirui, F., Mbui, J., Bukania, Z., Obala, A., Munge, K., Etyang, A., & Barasa, E. (2020b). Patient costs of diabetes mellitus care in public health care facilities in Kenya. International Journal of Health Planning and Management, 35(1), 290–308. https://doi.org/10.1002/hpm.2905
26. Park, P. H., & Pastakia, S. D. (2018). Access to Hemoglobin A1c in Rural Africa: A Difficult Reality with Severe Consequences. In Journal of Diabetes Research (Vol. 2018). https://doi.org/10.1155/2018/6093595
27. Peters, M. L., Huisman, E. L., Schoonen, M., & Wolffenbuttel, B. H. R. (2017). The current total economic burden of diabetes mellitus in the Netherlands. Netherlands Journal of Medicine, 75(7).
28. Preis, S. R., Hwang, S. J., Coady, S., Pencina, M. J., D’Agostino, R. B., Savage, P. J., Levy, D., & Fox, C. S. (2009). Trends in all-cause and cardiovascular disease mortality among women and men with and without diabetes mellitus in the framingham heart study, 1950 to 2005. Circulation, 119(13). https://doi.org/10.1161/CIRCULATIONAHA.108.829176
Saeedi, P., Petersohn, I., Salpea, P., Malanda, B., Karuranga, S., Unwin, N., Colagiuri, S., Guariguata, L., Motala, A. A., Ogurtsova, K., Shaw, J. E., Bright, D., & Williams, R. (2019). Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Research and Clinical Practice, 157.
Published
2022-07-31
How to Cite
Adamjee, E., & Harerimana, J. de D. (2022). Estimating the Economic Burden of Diabetes Mellitus in Kenya: a Cost of Illness Study. European Scientific Journal, ESJ, 18(22), 104. https://doi.org/10.19044/esj.2022.v18n22p104
Section
ESJ Social Sciences
Copyright (c) 2022 Ebrahim Adamjee, Jean de Dieu Harerimana
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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