Catastrophic pharmaceutical expenditure in patients with type 2 diabetes in Iran

International Journal for Equity in Health

Research

Jalal Arabloo¹  Leila Zarei²  Farzad Peiravian³  Najmeh Moradi⁴  Motahareh Mahi-Birjand⁵  Nazafarin Hatami-Mazinani⁶  Zaheer-Ud-Din Babar⁷ 

[1] Assistant Professor in Health Policy Making, Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran;Assistant Professor in Pharmacoeconomics and Pharma Management, Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Fars, Iran;Assistant Professor in Pharmacoeconomics and Pharma Management, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran;Assistant Professor in Pharmacoeconomics and Pharmaceutical Management, Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran;Department of Clinical Pharmacy, School of Pharmacy, Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran;Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran;Professor in Medicines and Healthcare. Department of Pharmacy, University of Huddersfield, HD1 3DH, Queensgate, Huddersfield, UK;

关键词: Diabetes;    Catastrophic expenditures;    Medication;    Out of pocket;    Middle-income countries;   

DOI  :  10.1186/s12939-022-01791-5

 received in 2022-05-14, accepted in 2022-11-13,  发布年份 2022

来源: Springer

【 摘 要 】

ObjectivesThis study aimed to assess the financial burden of out-of-pocket (OOP) payments to purchase antidiabetic medicines for type 2 patients in Iran.MethodThe “budget share” and “capacity to pay” approaches were employed to assess the catastrophic pharmaceutical expenditures of antidiabetic medication therapies. The catastrophic thresholds were adjusted for pharmaceutical sectors. The data was 2019 monthly household expenditures in rural and urban areas, insurance coverages of antidiabetic medicines and patients' out-of-pocket (OOP) payments in 30-day treatment schedules.ResultsThe results show that expenditure on diabetes medication therapies in the form of mono-dual therapy and some cases triple oral therapies were not catastrophic even for rural households. Insulin puts patients at risk of catastrophic pharmaceutical expenditures when added to the treatment schedules, and lack of financial protection intensifies it. In general, the poorer households and those resistant to first-line treatments were at increased risk of catastrophic pharmaceutical expenditures. The number of treatments that put patients at risk of catastrophic pharmaceutical expenditure in "budget share" was higher than the "capacity to pay" approach.ConclusionsAssessing medication treatment affordability instead of a single medicine assessment is needed. Assessment could be done by utilizing a macro-level data approach and applying adjusted pharmaceutical sector threshold values. Considering the variation between treatment schedules that put patients at risk of catastrophic pharmaceutical expenditures, targeted pharmaceutical policies and reimbursement decisions are recommended to promote Universal Health Coverage (UHC) and to protect vulnerable populations from hardship.

【 授权许可】

CC BY   
© The Author(s) 2022

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