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Meta-Analysis
. 2015 Jul 22;10(7):e0132505.
doi: 10.1371/journal.pone.0132505. eCollection 2015.

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  1 , Atefeh Mashayekhi  2 , Hamid R Baradaran  2 , AliAkbar Haghdoost  3 , Ashkan Afshin  4
Affiliations
Meta-Analysis

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 et al. PLoS One. .

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.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Markov model structure.
Fig 2
Fig 2. Total estimated diagnosed and undiagnosed DM population size through 2030.
Fig 3
Fig 3. Total estimated direct and indirect cost of DM through 2030.
Fig 4
Fig 4. Total estimated DM population size through 2030 in base-, worst- and best-case scenario.
Fig 5
Fig 5. Total estimated direct cost of DM through 2030 in base-, worst- and best-case scenario.
Fig 6
Fig 6. Total estimated indirect cost of DM through 2030 in base-, worst- and best-case scenario.
See this image and copyright information in PMC

References

    1. Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, et al. (2013) Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. The Lancet 380: 2095–2128. - PMC - PubMed
    1. Guariguata L, Whiting D, Hambleton I, Beagley J, Linnenkamp U, et al. (2013) Global estimates of diabetes prevalence for 2013 and projections for 2035 for the IDF Diabetes Atlas. Diabetes Research and Clinical Practice. - PubMed
    1. (2013) International Diabetes Federation IDF Diabetes Atlas 6th edn. International Diabetes Federation; Brussels Belgium.
    1. Ng CS, Lee JY, Toh MP, Ko Y (2014) Cost-of-illness studies of diabetes mellitus: a systematic review. Diabetes Res Clin Pract 105: 151–163. 10.1016/j.diabres.2014.03.020 - DOI - PubMed
    1. Association AD (2013) Economic Costs of Diabetes in the US in 2012. Diabetes Care 36: 1033–1046. 10.2337/dc12-2625 - DOI - PMC - PubMed

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