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Projection of Diabetes Population Size and Associated Economic Burden through 2030 in Iran: Evidence from Micro-Simulation Markov Model and Bayesian Meta-Analysis

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  • Mehdi Javanbakht
  • Atefeh Mashayekhi
  • Hamid R Baradaran
  • AliAkbar Haghdoost
  • Ashkan Afshin

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.

Suggested Citation

  • Mehdi Javanbakht & Atefeh Mashayekhi & Hamid R Baradaran & AliAkbar Haghdoost & Ashkan Afshin, 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, Public Library of Science, vol. 10(7), pages 1-17, July.
    • Handle: RePEc:plo:pone00:0132505
    DOI: 10.1371/journal.pone.0132505
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    References listed on IDEAS

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    1. Mark Roberts & Louise B. Russell & A. David Paltiel & Michael Chambers & Phil McEwan & Murray Krahn, 2012. "Conceptualizing a Model," Medical Decision Making, , vol. 32(5), pages 678-689, September.
    2. Mehdi Javanbakht & Hamid R Baradaran & Atefeh Mashayekhi & Ali Akbar Haghdoost & Mohammad E Khamseh & Erfan Kharazmi & Aboozar Sadeghi, 2011. "Cost-of-Illness Analysis of Type 2 Diabetes Mellitus in Iran," PLOS ONE, Public Library of Science, vol. 6(10), pages 1-7, October.
    3. Briggs, Andrew & Sculpher, Mark & Claxton, Karl, 2006. "Decision Modelling for Health Economic Evaluation," OUP Catalogue, Oxford University Press, number 9780198526629.
    4. Jones, A.P. & Homer, J.B. & Murphy, D.L. & Essien, J.D.K. & Milstein, B. & Seville, D.A. & Barnes, K., 2006. "Understanding diabetes population dynamics through simulation modeling and experimentation," American Journal of Public Health, American Public Health Association, vol. 96(3), pages 488-494.
    5. Carolyn M. Rutter & Alan M. Zaslavsky & Eric J. Feuer, 2011. "Dynamic Microsimulation Models for Health Outcomes," Medical Decision Making, , vol. 31(1), pages 10-18, January.
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    1. Rahill Sadat Shahtaheri & Yahya Bayazidi & Majid Davari & Abbas Kebriaeezadeh & Sepideh Yousefi & Alireza Mahdavi Hezaveh & Abolfazl Sadeghi & Ahmed Hayder Mohsin Lami & Hadi Abbasian, 2022. "Long-term cost-effectiveness of quality of diabetes care; experiences from private and public diabetes centers in Iran," Health Economics Review, Springer, vol. 12(1), pages 1-7, December.

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