Published online Nov 25, 2015. doi: 10.4239/wjd.v6.i16.1312
Peer-review started: June 6, 2015
First decision: June 18, 2015
Revised: August 27, 2015
Accepted: September 29, 2015
Article in press: September 30, 2015
Published online: November 25, 2015
AIM: To design a medical cost calculator and show that diabetes care is beyond reach of the majority particularly patients with complications.
METHODS: Out-of-pocket expenditures of patients for medical treatment of type-2 diabetes were estimated based on price data collected in Benin, Burkina Faso, Guinea and Mali. A detailed protocol for realistic medical care of diabetes and its complications in the African context was defined. Care components were based on existing guidelines, published data and clinical experience. Prices were obtained in public and private health facilities. The cost calculator used Excel. The cost for basic management of uncomplicated diabetes was calculated per person and per year. Incremental costs were also computed per annum for chronic complications and per episode for acute complications.
RESULTS: Wide variations of estimated care costs were observed among countries and between the public and private healthcare system. The minimum estimated cost for the treatment of uncomplicated diabetes (in the public sector) would amount to 21%-34% of the country’s gross national income per capita, 26%-47% in the presence of retinopathy, and above 70% for nephropathy, the most expensive complication.
CONCLUSION: The study provided objective evidence for the exorbitant medical cost of diabetes considering that no medical insurance is available in the study countries. Although the calculator only estimates the cost of inaction, it is innovative and of interest for several stakeholders.
Core tip: The costs of medical treatment of diabetes are poorly documented in sub-Saharan Africa, while such data are of interest for several stakeholders and useful for advocacy. There is a lack of tools to make these estimations. We describe a standardized, innovative and user-friendly medical cost calculator and provide the results of its use in four countries. It was developed in West-Africa but it is also relevant for other African countries and perhaps even in Asia provided the standard treatment protocol is deemed appropriate.