Economic Burden Evaluation of Cutaneous Leishmaniasis in Iran

Background: Cutaneous leishmaniasis as a prevalent sandfly borne disease in many tropical and subtropical countries has adverse economic consequences for patients and health care systems. Objectives: The aim of present study was evaluation of the economic burden of cutaneous leishmaniasis on families and consequently the health care systems in all of 31 provinces of Iran for year 2017. Methods: This cross-sectional study was carried out based on available data from 14125 cutaneous leishmaniasis cases in all endemic foci of Iran in 2017. The direct and indirect costs paid by patients and government health care systems were extracted through accounting documents via patients and health staff in the office of zoonotic diseases control, CDC, Iranian Ministry of Health. The data was recorded in researcher-made forms. Activity based costing (ABC) is used to evaluate economic burden of health care services in Iran to patients with of CL. Two financial software suites namely Azarakhsh and Roozamad have been employed in addition to Excel V. 2010. Results: The incidence of cutaneous leishmaniasis in Iran was 17.82 per 100,000 people (14125/79,262,000). Economic burden of the disease was estimated at 291,046,430,125 Rials ($ 5,820,928). The average direct, indirect (overhead) and governmental costs paid for each case with CL was 10,631,250 Rials ($ 212.5), 9,653,807 Rials ($ 193) and 20,285,057 Rials ($ 405.5) respectively. The out of pocket for each patient was around 320 thousand Rials ($ 7). Total costs (governmental + out of pocket) during this period was estimated at 20,605,057 Rials ($ 412.5) expenditure per capita. Conclusions: Direct and indirect costs associated with diagnosis and treatment of CL in Iran that was provided by governmental health care systems and out-of-pockets are considerably high. It can have a great economic impact on families and consequently the health care systems. It seems adopting suitable preventive methods will be more affordable for people who live at risk of the disease.