Projection of diabetes population size and associated economic burden through 2030 in Iran: Evidence from micro-simulation Markov model and Bayesian meta-analysis

Javanbakht, M. and Mashayekhi, A. and Baradaran, H.R. and Haghdoost, A.A. and Afshin, A. (2015) Projection of diabetes population size and associated economic burden through 2030 in Iran: Evidence from micro-simulation Markov model and Bayesian meta-analysis. PLoS ONE, 10 (7).

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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 metaanalysis. 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 US1.71 billion direct and US1.93 billion indirect costs) in 2009 and is predicted to increase to 9.0 (in 2009 US) billion (including US4.2 billion direct and US4.8 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. © 2015 Javanbakht et al.

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