Projection of Diabetes Population Size and Associated Economic Burden through 2030 in Iran

Evidence from Micro-Simulation Markov Model and Bayesian Meta-Analysis

Mehdi Javanbakht, Atefeh Mashayekhi, Hamid R Baradaran, AliAkbar Haghdoost, Ashkan Afshin

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Abstract

BACKGROUND: The aim of this study was to estimate the economic burden of diabetes mellitus (DM) in Iran from 2009 to 2030.

METHODS: A Markov micro-simulation (MM) model was developed to predict the DM population size and associated economic burden. Age- and sex-specific prevalence and incidence of diagnosed and undiagnosed DM were derived from national health surveys. A systematic review was performed to identify the cost of diabetes in Iran and the mean annual direct and indirect costs of patients with DM were estimated using a random-effect Bayesian meta-analysis. Face, internal, cross and predictive validity of the MM model were assessed by consulting an expert group, performing sensitivity analysis (SA) and comparing model results with published literature and national survey reports. Sensitivity analysis was also performed to explore the effect of uncertainty in the model.

RESULTS: We estimated 3.78 million cases of DM (2.74 million diagnosed and 1.04 million undiagnosed) in Iran in 2009. This number is expected to rise to 9.24 million cases (6.73 million diagnosed and 2.50 million undiagnosed) by 2030. The mean annual direct and indirect costs of patients with DM in 2009 were US$ 556 (posterior standard deviation, 221) and US$ 689 (619), respectively. Total estimated annual cost of DM was $3.64 (2009 US$) billion (including US$1.71 billion direct and US$1.93 billion indirect costs) in 2009 and is predicted to increase to $9.0 (in 2009 US$) billion (including US$4.2 billion direct and US$4.8 billion indirect costs) by 2030.

CONCLUSIONS: The economic burden of DM in Iran is predicted to increase markedly in the coming decades. Identification and implementation of effective strategies to prevent and manage DM should be considered as a public health priority.

Original languageEnglish
Article numbere0132505
Number of pages17
JournalPloS ONE
Volume10
Issue number7
Early online date22 Jul 2015
DOIs
Publication statusPublished - 22 Jul 2015

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Bayes Theorem
Medical problems
diabetes mellitus
Iran
Population Density
meta-analysis
diabetes
Meta-Analysis
Diabetes Mellitus
population size
Economics
economics
Costs and Cost Analysis
Costs
national surveys
simulation models
Sensitivity analysis
Health Priorities
model uncertainty
systematic review

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Projection of Diabetes Population Size and Associated Economic Burden through 2030 in Iran : Evidence from Micro-Simulation Markov Model and Bayesian Meta-Analysis. / Javanbakht, Mehdi; Mashayekhi, Atefeh; Baradaran, Hamid R; Haghdoost, AliAkbar; Afshin, Ashkan.

In: PloS ONE, Vol. 10, No. 7, e0132505, 22.07.2015.

Research output: Contribution to journalArticle

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title = "Projection of Diabetes Population Size and Associated Economic Burden through 2030 in Iran: Evidence from Micro-Simulation Markov Model and Bayesian Meta-Analysis",
abstract = "BACKGROUND: The aim of this study was to estimate the economic burden of diabetes mellitus (DM) in Iran from 2009 to 2030.METHODS: A Markov micro-simulation (MM) model was developed to predict the DM population size and associated economic burden. Age- and sex-specific prevalence and incidence of diagnosed and undiagnosed DM were derived from national health surveys. A systematic review was performed to identify the cost of diabetes in Iran and the mean annual direct and indirect costs of patients with DM were estimated using a random-effect Bayesian meta-analysis. Face, internal, cross and predictive validity of the MM model were assessed by consulting an expert group, performing sensitivity analysis (SA) and comparing model results with published literature and national survey reports. Sensitivity analysis was also performed to explore the effect of uncertainty in the model.RESULTS: We estimated 3.78 million cases of DM (2.74 million diagnosed and 1.04 million undiagnosed) in Iran in 2009. This number is expected to rise to 9.24 million cases (6.73 million diagnosed and 2.50 million undiagnosed) by 2030. The mean annual direct and indirect costs of patients with DM in 2009 were US$ 556 (posterior standard deviation, 221) and US$ 689 (619), respectively. Total estimated annual cost of DM was $3.64 (2009 US$) billion (including US$1.71 billion direct and US$1.93 billion indirect costs) in 2009 and is predicted to increase to $9.0 (in 2009 US$) billion (including US$4.2 billion direct and US$4.8 billion indirect costs) by 2030.CONCLUSIONS: The economic burden of DM in Iran is predicted to increase markedly in the coming decades. Identification and implementation of effective strategies to prevent and manage DM should be considered as a public health priority.",
author = "Mehdi Javanbakht and Atefeh Mashayekhi and Baradaran, {Hamid R} and AliAkbar Haghdoost and Ashkan Afshin",
note = "Acknowledgments The authors would like to thank kindly all advisors and colleagues, for their valuable technical support. We would like to thank you Ms Laura Marie Dysart for editing the paper.",
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T2 - Evidence from Micro-Simulation Markov Model and Bayesian Meta-Analysis

AU - Javanbakht, Mehdi

AU - Mashayekhi, Atefeh

AU - Baradaran, Hamid R

AU - Haghdoost, AliAkbar

AU - Afshin, Ashkan

N1 - Acknowledgments The authors would like to thank kindly all advisors and colleagues, for their valuable technical support. We would like to thank you Ms Laura Marie Dysart for editing the paper.

PY - 2015/7/22

Y1 - 2015/7/22

N2 - BACKGROUND: The aim of this study was to estimate the economic burden of diabetes mellitus (DM) in Iran from 2009 to 2030.METHODS: A Markov micro-simulation (MM) model was developed to predict the DM population size and associated economic burden. Age- and sex-specific prevalence and incidence of diagnosed and undiagnosed DM were derived from national health surveys. A systematic review was performed to identify the cost of diabetes in Iran and the mean annual direct and indirect costs of patients with DM were estimated using a random-effect Bayesian meta-analysis. Face, internal, cross and predictive validity of the MM model were assessed by consulting an expert group, performing sensitivity analysis (SA) and comparing model results with published literature and national survey reports. Sensitivity analysis was also performed to explore the effect of uncertainty in the model.RESULTS: We estimated 3.78 million cases of DM (2.74 million diagnosed and 1.04 million undiagnosed) in Iran in 2009. This number is expected to rise to 9.24 million cases (6.73 million diagnosed and 2.50 million undiagnosed) by 2030. The mean annual direct and indirect costs of patients with DM in 2009 were US$ 556 (posterior standard deviation, 221) and US$ 689 (619), respectively. Total estimated annual cost of DM was $3.64 (2009 US$) billion (including US$1.71 billion direct and US$1.93 billion indirect costs) in 2009 and is predicted to increase to $9.0 (in 2009 US$) billion (including US$4.2 billion direct and US$4.8 billion indirect costs) by 2030.CONCLUSIONS: The economic burden of DM in Iran is predicted to increase markedly in the coming decades. Identification and implementation of effective strategies to prevent and manage DM should be considered as a public health priority.

AB - BACKGROUND: The aim of this study was to estimate the economic burden of diabetes mellitus (DM) in Iran from 2009 to 2030.METHODS: A Markov micro-simulation (MM) model was developed to predict the DM population size and associated economic burden. Age- and sex-specific prevalence and incidence of diagnosed and undiagnosed DM were derived from national health surveys. A systematic review was performed to identify the cost of diabetes in Iran and the mean annual direct and indirect costs of patients with DM were estimated using a random-effect Bayesian meta-analysis. Face, internal, cross and predictive validity of the MM model were assessed by consulting an expert group, performing sensitivity analysis (SA) and comparing model results with published literature and national survey reports. Sensitivity analysis was also performed to explore the effect of uncertainty in the model.RESULTS: We estimated 3.78 million cases of DM (2.74 million diagnosed and 1.04 million undiagnosed) in Iran in 2009. This number is expected to rise to 9.24 million cases (6.73 million diagnosed and 2.50 million undiagnosed) by 2030. The mean annual direct and indirect costs of patients with DM in 2009 were US$ 556 (posterior standard deviation, 221) and US$ 689 (619), respectively. Total estimated annual cost of DM was $3.64 (2009 US$) billion (including US$1.71 billion direct and US$1.93 billion indirect costs) in 2009 and is predicted to increase to $9.0 (in 2009 US$) billion (including US$4.2 billion direct and US$4.8 billion indirect costs) by 2030.CONCLUSIONS: The economic burden of DM in Iran is predicted to increase markedly in the coming decades. Identification and implementation of effective strategies to prevent and manage DM should be considered as a public health priority.

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