Prevention and control of non-communicable diseases in iran: the case for Investment.

Clinical intervention Cost; burden Non-communicable diseases Policy intervention Return on investment

Journal

BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562

Informations de publication

Date de publication:
24 06 2022
Historique:
received: 05 09 2021
accepted: 06 06 2022
entrez: 23 6 2022
pubmed: 24 6 2022
medline: 28 6 2022
Statut: epublish

Résumé

Non-communicable diseases are imposing a considerable burden on Iran. This study aims to assess the Return on Investment (ROI) for implementation of Non-communicable diseases (NCDs) prevention program in Iran. Four disease groups including cardiovascular diseases, diabetes, cancer, and respiratory diseases were included in our ROI analysis. The study followed four steps: 1) Estimating the total economic burden of NCDs using the Cost-of-Illness approach. 2) Estimating the total costs of implementing clinical and preventive interventions using an ingredient based costing at delivering level and a program costing method at central level.3) Calculating health impacts and economic benefits of interventions using the impact measures of avoided incidence, avoided mortality, healthy life years (HLYs) gained, and avoided direct treatment costs. 4) Calculating the ROI for each intervention in 5- and 15- year time horizons. The total economic burden of NCDs to the Iranian economy was IRR 838.49 trillion per year (2018), which was equivalent to 5% of the country's annual Gross Domestic Product (GDP). The package of NCD will lead to 549 000 deaths averted and 2 370 000 healthy life years gained over 15 years, and, financially, Iranian economy will gain IRR 542.22 trillion over 15 years. The highest ROI was observed for the package of physical activity interventions, followed by the interventions addressing salt, tobacco package and clinical interventions. Conclusions NCDs in Iran are causing a surge in health care costs and are contributing to reduced productivity. Those actions to prevent NCDs in Iran, as well as yielding to a notable health impact, are giving a good economic return to the society. This study underscores an essential need for establishment of a national multi-sectorial NCD coordination mechanism to bring together and strengthen existing cross-agency initiatives on NCDs.

Sections du résumé

BACKGROUND
Non-communicable diseases are imposing a considerable burden on Iran. This study aims to assess the Return on Investment (ROI) for implementation of Non-communicable diseases (NCDs) prevention program in Iran.
METHODS
Four disease groups including cardiovascular diseases, diabetes, cancer, and respiratory diseases were included in our ROI analysis. The study followed four steps: 1) Estimating the total economic burden of NCDs using the Cost-of-Illness approach. 2) Estimating the total costs of implementing clinical and preventive interventions using an ingredient based costing at delivering level and a program costing method at central level.3) Calculating health impacts and economic benefits of interventions using the impact measures of avoided incidence, avoided mortality, healthy life years (HLYs) gained, and avoided direct treatment costs. 4) Calculating the ROI for each intervention in 5- and 15- year time horizons.
RESULTS
The total economic burden of NCDs to the Iranian economy was IRR 838.49 trillion per year (2018), which was equivalent to 5% of the country's annual Gross Domestic Product (GDP). The package of NCD will lead to 549 000 deaths averted and 2 370 000 healthy life years gained over 15 years, and, financially, Iranian economy will gain IRR 542.22 trillion over 15 years. The highest ROI was observed for the package of physical activity interventions, followed by the interventions addressing salt, tobacco package and clinical interventions. Conclusions NCDs in Iran are causing a surge in health care costs and are contributing to reduced productivity. Those actions to prevent NCDs in Iran, as well as yielding to a notable health impact, are giving a good economic return to the society. This study underscores an essential need for establishment of a national multi-sectorial NCD coordination mechanism to bring together and strengthen existing cross-agency initiatives on NCDs.

Identifiants

pubmed: 35739516
doi: 10.1186/s12889-022-13615-w
pii: 10.1186/s12889-022-13615-w
pmc: PMC9229124
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1248

Subventions

Organisme : World Health Organization
ID : 001
Pays : International

Informations de copyright

© 2022. The Author(s).

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Auteurs

Mahmood Yousefi (M)

Department of Health Economics, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran. mahmoodyousefi59@gmail.com.

Ilker Dastan (I)

Health Policy, WHO Country Office, Dushanbe, Tajikistan.

Farbod Alinezhad (F)

Bouve Colleage of Health Sciences, Northeastern University, Boston, MA, USA.

Mansour Ranjbar (M)

National Professional Officer, NCD and Mental Health Unit Head, WHO , Tehran, Iran.

Christoph Hamelmann (C)

World Health Organization Representative in I.R.Iran, WHO, Tehran, Iran.

Afshin Ostovar (A)

Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Alireza Moghisi (A)

Deputy General Director for NCD Management Office, Ministry of Health and Medical Education, Tehran, IR, Iran.

Sima Mohammadi (S)

Islamic Azad University, Tehran, Iran.

Awad Mataria (A)

Universal Health Coverage/Health Systems (UHS), World health Organization, Regional Office for Eastern Mediterranean (WHO-EMRO), Cairo, Egypt.

Asmus Hammerich (A)

UHC/NCDs, World Health Organization, Regional Office for Eastern Mediterranean (WHO-EMRO), Cairo, Egypt.

Slim Slama (S)

Non Communicable Diseases Prevention (NCP), UHC/NCDs, World Health Organization, Regional Office for Eastern Mediterranean (WHO-EMRO), Cairo, Egypt.

Nasim Pourghazian (N)

Non Communicable Diseases Prevention (NCP), UHC/NCDs, World Health Organization, Regional Office for Eastern Mediterranean (WHO-EMRO), Cairo, Egypt.

Alireza Mahdavi Hezaveh (AM)

Cardio Vascular Diseases Prevention Department, NCD Management Office, Ministry of Health and Medical Education, Tehran, IR, Iran.

Behzad Valizadeh (B)

National Tobacco Control Secretariat, Ministry of Health and Medical Education, Tehran, IR, Iran.

Parisa Torabi (P)

National Manager of Clinical Nutrition Group, Ministry of Health and Medical Education, Tehran, IR, Iran.

Mehdi Najmi (M)

Director of Respiratory Diseases Prevention Department, NCD Management Office, Ministry of Health and Medical Education, Tehran, IR, Iran.

Mohammad Moradi (M)

Expert of Cardio Vascular Diseases Prevention Department, NCD Management Office, Ministry of Health and Medical Education, Tehran, IR, Iran.

Alieh Hodjatzadeh (A)

Expert of Cardio Vascular Diseases Prevention Department, NCD Management Office, Ministry of Health and Medical Education, Tehran, IR, Iran.

Fatemeh Keshvari-Shad (F)

Department of Health Economics, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.

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