ArticleInternational journal for equity in health2022
Catastrophic pharmaceutical expenditure in patients with type 2 diabetes in Iran.
Article in International journal for equity in health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.
- Financial Toxicity in Diabetes: The State of What We Know.Current diabetes reports · 2025Pooled it
- Inequality in prevalence of unmedicated hypertension or diabetes among older Filipinos: analysis of nationally representative survey data.International journal of cardiology. Cardiovascular risk and prevention · 2026Article
- Optimal insurance coverage and pricing of outpatient drugs in Iran: a cost- and chronicity-based adaptation of the vertical equity model.International journal for equity in health · 2026Article
- Economic Burden of Type 2 Diabetes Mellitus Among Patients Attending Ho Teaching Hospital in the Ho Municipality, Ghana: A Cross-Sectional Study.Health science reports · 2026Article
- Socioeconomic determinants of affordability of medication: a panel data econometric analysis in Iran.BMC health services research · 2025Article
- Exploring dental and medicine health expenditures in Iran: financial protection and inequality analysis.Journal of health, population, and nutrition · 2025Article
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
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.
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