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This manuscript presents the results of an analysis that highlights the challenges of diabetes as a global public health problem. The analysis was conducted in two phases: the first phase deals with primary data and results of a longitudinal study to provide evidence on the Mexican case. Regarding epidemiological changes between 2014 and 2016, there is an increase of 9--13% (p < .001). Comparing the economic burden from epidemiological changes in 2014 versus 2016 (p < .05), there is a 26% increase. The total amount spent on diabetes in 2015 (US dollars) was $ 8,974,662,570. This includes $ 3,981,426,810 in direct costs and $ 4993,235,752 in indirect costs. The second phase emphasises the analysis of diabetes as a major global public health challenge in the Americas. For this purpose a comparative analysis of epidemiological trends was carried out in seven selected Latin American countries (LACs). The results of both phases showed evidence leading to the conclusion that if the risk factors and models of health care remain as they currently are in LACs, there will be a high economic impact to patients' pockets and to health systems, which could lead to financial collapse. [ABSTRACT FROM AUTHOR]

Background: The financial implications of the increase in the prevalence of diabetes in middle-income countries represents one of the main challenges to health system financing and to the society as a whole. The objective of this study was to estimate the economic cost of diabetes in Latin America and the Caribbean (LAC) in 2015.Methods: The study used a prevalence-based approach to estimate the direct and indirect costs related to diabetes in 29 LAC countries in 2015. Direct costs included health care expenditures such as medications (insulin and oral hypoglycemic agents), tests, consultations, hospitalizations, emergency visits and treating complications. Two different scenarios (S1 and S2) were used to analyze direct cost. S1 assumed conservative estimates while S2 assumed broader coverage of medication and services. Indirect costs included lost resources due to premature mortality, temporary and permanent disabilities.Results: In 2015 over 41 million adults (20 years of age and more) were estimated to have Diabetes Mellitus in LAC. The total indirect cost attributed to Diabetes was US$ 57.1 billion, of which US$ 27.5 billion was due to premature mortality, US$16.2 billion to permanent disability, and US$ 13.3 billion to temporary disability. The total direct cost was estimated between US$ 45 and US$ 66 billion, of which the highest estimated cost was due to treatment of complications (US$ 1 616 to US$ 26 billion). Other estimates indicated the cost of insulin between US$ 6 and US$ 11 billion; oral medication US$ 4 to US$ 6 billion; consultations between US$ 5 and US$ 6 billion; hospitalization US$ 10 billion; emergency visits US$ 1 billion; test and laboratory exams between US$ 1 and US$ 3 million. The total cost of diabetes in 2015 in LAC was estimated to be between US$ 102 and US$ 123 billion. On average, the annual cost of treating one case of diabetes mellitus (DM) in LAC was estimated between US$ 1088 and US$ 1818. Per capita National Health Expenditures averaged US$ 1061 in LAC.Conclusions: Diabetes represented a major economic burden to the countries of Latin America and the Caribbean in 2015. The estimates presented here are key information for decision-making that can be used in the formulation of policies and programs to achieve greater efficiency and effectiveness in the use of resources for diabetes prevention in the 29 countries of LAC. [ABSTRACT FROM AUTHOR]

The article discusses a study about the economic and social effects of diabetes and their impacts on health systems and patients from low- and middle-income countries (LMIC). Topics covered include the fight against diabetes in Ecuador, Guatemala, Cuba, Venezuela, Brazil, and Mexico, the changes and trends in the economic burden of diabetes and its complications, and an analysis of the cost-effectiveness of diabetes interventions.

Taking the Mexican case as a tracer of what is happening in Latin America on public health, we estimate the recent changes and challenges for the management of hypertension in older adults in the context of universal health coverage. The population base was 200, and 308 reported cases of older adults with hypertension. The cost-evaluation method used was based on the instrumentation and consensus technique. Regarding epidemiological changes for 2016 versus 2018, there is an increase of 21% (CI: 95%, p < 0.001). Comparing the economic impact in 2016 versus 2018 (CI: 95%, p < 0.001), the increase is 33%. The total amount estimated for hypertension in 2018 (in US dollars) was $ 1,896,520,273. It includes $ 898,064,979 as direct costs and $ 998,455,294 as indirect costs. The recent trends show that the financial requirements for the coming years do not guarantee the effectiveness of the coverage rates required for the elderly. In terms of catastrophic expenditure, the challenge is not minor, the greatest economic burden is for the pocket of patients and their families., (© 2020 John Wiley & Sons Ltd.)

The aim of this study was to assess the costs and financial consequences of epidemiological changes in hypertension in Mexico. The cost evaluation method to estimate costs was based on instrumentation techniques. To estimate the epidemiological changes and expected cases of hypertension in 2010-2012, three probabilistic models were constructed according to the Box-Jenkins technique. Comparing the economic impact, from 2010 to 2012 there will be a 24% increase in financial requirements (p < 0.05). The total cost of hypertension in 2011 will be US$ 5,733,350,291, including US$ 2,718,280,941 in direct costs and US$ 3,015,069,350 in indirect costs. If the risk factors and various healthcare models remain unaltered in the institutions analyzed here, the financial consequences will have a major impact on users' pockets, followed by social security providers and public healthcare providers. The authors suggest a revision in the planning, organization, and allocation of resources, particularly programs for health promotion and prevention of hypertension.

Background: Costs of health services for hypertension and the financial consequences of epidemiologic changes in this disease are important concerns for health systems in Latin America., Methods: We conducted longitudinal analyses of the economic impact of the epidemiologic changes on health care services for hypertension in the Mexican health care system. The cost evaluation method used was based on costing technique by production function and consensus techniques. To estimate the epidemiologic changes and financial consequences for the period 2005 to 2007, three probabilistic models were constructed according to the Box-Jenkins technique., Results: If changes are not implemented in prevention programs to reduce the effects of current risk factors, there will be increases in the number of patients with hypertension as well as in the financial burden to treat the disease. The amount allocated for hypertension in 2007, which will be 6% to 8% of the total health budget, is US$ 2,486,145,132. Of these, US$ 1,178,725,132 will be direct costs and US$ 1,307,420,000 will be indirect costs. Regarding epidemiologic changes for 2005 v 2007 (P < .05), an increase is expected, although results show a greater increase in insured populations., Conclusions: If the risk factors and different health programs remain as they currently are, the economic impact of expected epidemiologic changes on the social security system will be particularly strong. Another relevant financial factor is the appearance of internal competition in the allocation of financial resources among the main providers of health services for hypertension; this factor becomes even more complicated within each provider.