The costs of diabetes treatment in low- A nd middle-income countries: A systematic review

Corrina Moucheraud, Cosima Lenz, Michaella Latkovic, Veronika J. Wirtz

Research output: Contribution to journalReview articlepeer-review


Introduction The rising burden of diabetes in low- A nd middle-income countries may cause financial strain on individuals and health systems. This paper presents a systematic review of direct medical costs for diabetes (types 1 and 2) in low- A nd middle-income countries. Methods Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, databases (PubMed, International Bibliography of Social Science, EconLit) were searched for publications reporting direct medical costs of type 1 and 2 diabetes. Data were extracted from all peer-reviewed papers meeting inclusion criteria, and were standardised into per-patient-visit, per-patient-year and/or per-complication-case costs (2016 US$). Results The search yielded 584 abstracts, and 52 publications were included in the analysis. Most articles were from Asia and Latin America, and most focused on type 2 diabetes. Per-visit outpatient costs ranged from under $5 to over $40 (median: $7); annual inpatient costs ranged from approximately $10 to over $1000 (median: $290); annual laboratory costs ranged from under $5 to over $100 (median: $25); and annual medication costs ranged from $15 to over $500 (median: $177), with particularly wide variation found for insulin. Care for complications was generally high-cost, but varied widely across countries and complication types. Conclusion This review identified substantial variation in diabetes treatment costs; some heterogeneity could be mitigated through improved methods for collecting, analysing and reporting data. Diabetes is a costly disease to manage in low- A nd middle-income countriesand should be a priority for the global health community seeking to achieve Universal Health Coverage.

Original languageEnglish (US)
Article numbere001258
JournalBMJ Global Health
Issue number1
StatePublished - Feb 1 2019


  • diabetes
  • health economics

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health


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