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Darba S, Safaei N, Mahboub-Ahari A, et al. Direct and Indirect Costs Associated with Coronary Artery (Heart) Disease in Tabriz, Iran. Risk Manag Healthc Policy. 2020;13:969-978doi: 10.2147/RMHP.S261612.
Darba, S., Safaei, N., Mahboub-Ahari, A., Nosratnejad, S., Alizadeh, G., Ameri, H., & Yousefi, M. (2020). Direct and Indirect Costs Associated with Coronary Artery (Heart) Disease in Tabriz, Iran. Risk management and healthcare policy, 13969-978. https://doi.org/10.2147/RMHP.S261612
Darba, Shahla, et al. "Direct and Indirect Costs Associated with Coronary Artery (Heart) Disease in Tabriz, Iran." Risk management and healthcare policy vol. 13 (2020): 969-978. doi: https://doi.org/10.2147/RMHP.S261612
Darba S, Safaei N, Mahboub-Ahari A, Nosratnejad S, Alizadeh G, Ameri H, Yousefi M. Direct and Indirect Costs Associated with Coronary Artery (Heart) Disease in Tabriz, Iran. Risk Manag Healthc Policy. 2020 Jul 31;13:969-978. doi: 10.2147/RMHP.S261612. eCollection 2020. PMID: 32801971; PMCID: PMC7406327.
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Risk Manag Healthc Policy. 2020 Jul 31;13:969-978. doi: 10.2147/RMHP.S261612. eCollection 2020.

Direct and Indirect Costs Associated with Coronary Artery (Heart) Disease in Tabriz, Iran.

Risk management and healthcare policy

Shahla Darba, Naser Safaei, Alireza Mahboub-Ahari, Shirin Nosratnejad, Gisoo Alizadeh, Hosein Ameri, Mahmood Yousefi

Affiliations

  1. Department of Health Economics, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
  2. Madani Heart Center, Tabriz University of Medical Sciences, Tabriz, Iran.
  3. Department of Health Economics, Iranian Center of Excellence in Health Services Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
  4. Department of Health Policy and Management, Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
  5. Health Policy and Management Research, Department of Health Care Management, School of Public Health, Shahid Sadoughi University of Medical Science, Yazd, Iran.

PMID: 32801971 PMCID: PMC7406327 DOI: 10.2147/RMHP.S261612

Abstract

PURPOSE: Cardiovascular diseases (CVDs) are the major causes of mortalities worldwide. This study was conducted to evaluate the direct and indirect costs of coronary artery disease (CAD) in Iran.

PATIENTS AND METHODS: This is a prevalence-based cost-of-illness (COI) study that estimates the direct and indirect costs of CAD. The study conducted over a six-month period from April to September in 2017. Patients were recruited from Madani hospital in Tabriz, Iran. A total of 379 patients were investigated from societal perspective. Direct costs were estimated using the bottom-up costing approach and indirect costs were estimated using the Human Capital (HC) approach. A generalized linear model of regression was used to explore the relation between total cost and socio-demographic variables. The total annual mean cost was compared to Gross Domestic Product (GDP) per capita which was reported in the form of Purchasing Power Parity (PPP) index. To deal with uncertainty, one-way sensitivity analysis was performed.

RESULTS: Total costs per patient in one year were estimated to be IRR 63452290.17 ($PPP 7736.19) at a 95% confidence interval (58191511.73-68713068.60), the biggest part of which is related to direct medical costs with IRR 33884019.53 per year ($PPP 4131.18) (54%). Direct non-medical costs were estimated IRR 1655936.68 ($PPP 201.89) per patient (2%) and indirect costs were estimated IRR 27912333.97 per patient ($PPP 3403.11) (44%), which 62% of indirect costs is related to patients' work absenteeism.

CONCLUSION: This study estimates the direct (56%) and indirect (44%) costs associated with CAD. The study explores the essential drivers of the costs and provides the magnitude of the burden in terms of the share of GDP. The outcomes can be used in priority setting, in particular for cost benefit analysis, and adopting new policies regarding insurance coverage and equity issues.

© 2020 Darba et al.

Keywords: coronary heart disease (CHD); cost-disease analysis; direct cost; indirect cost

Conflict of interest statement

The authors report no conflicts of interest in this work.

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