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Review
. 2013 Aug 16:11:31.
doi: 10.1186/1478-4505-11-31.

The financial burden from non-communicable diseases in low- and middle-income countries: a literature review

Hyacinthe Tchewonpi Kankeu  1 , Priyanka Saksena, Ke Xu, David B Evans
Affiliations
Review

The financial burden from non-communicable diseases in low- and middle-income countries: a literature review

Hyacinthe Tchewonpi Kankeu et al. Health Res Policy Syst. .

Abstract

Non-communicable diseases (NCDs) were previously considered to only affect high-income countries. However, they now account for a very large burden in terms of both mortality and morbidity in low- and middle-income countries (LMICs), although little is known about the impact these diseases have on households in these countries. In this paper, we present a literature review on the costs imposed by NCDs on households in LMICs. We examine both the costs of obtaining medical care and the costs associated with being unable to work, while discussing the methodological issues of particular studies. The results suggest that NCDs pose a heavy financial burden on many affected households; poor households are the most financially affected when they seek care. Medicines are usually the largest component of costs and the use of originator brand medicines leads to higher than necessary expenses. In particular, in the treatment of diabetes, insulin--when required--represents an important source of spending for patients and their families. These financial costs deter many people suffering from NCDs from seeking the care they need. The limited health insurance coverage for NCDs is reflected in the low proportions of patients claiming reimbursement and the low reimbursement rates in existing insurance schemes. The costs associated with lost income-earning opportunities are also significant for many households. Therefore, NCDs impose a substantial financial burden on many households, including the poor in low-income countries. The financial costs of obtaining care also impose insurmountable barriers to access for some people, which illustrates the urgency of improving financial risk protection in health in LMIC settings and ensuring that NCDs are taken into account in these systems. In this paper, we identify areas where further research is needed to have a better view of the costs incurred by households because of NCDs; namely, the extension of the geographical scope, the inclusion of certain diseases hitherto little studied, the introduction of a time dimension, and more comparisons with acute illnesses.

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Figure 1
Figure 1
Framework for the analysis of economic impacts of NCDs on households (modified from McIntyre et al. [10]).
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References

    1. World Health Organization. Global Status Report on Non-communicable Diseases 2010. Geneva: World Health Organization; 2011.
    1. United Nations. Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases. New York: United Nations: 66th session of the General Assembly, High-level Meeting on the Prevention and Control of Non-communicable Diseases; 2011.
    1. Lin J-M, Resch SC, Brimmer DJ, Johnson A, Kennedy S, Burstein N, Simon CJ. The economic impact of chronic fatigue syndrome in Georgia: direct and indirect costs. Cost Eff Resour Alloc. 2011;9:1. doi: 10.1186/1478-7547-9-1. - DOI - PMC - PubMed
    1. Schofield D, Passey M, Percival R, Shrestha R, Callander E, Kelly S. Retiring early with cardiovascular disease - impact on individual’s financial assets. Int J Cardiol. 2010;92:125–126. - PubMed
    1. Pollack CE, Griffin BA, Lynch J. Housing affordability and health among homeowners and renters. Am J Prev Med. 2010;39:515–521. doi: 10.1016/j.amepre.2010.08.002. - DOI - PubMed
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