COST OF ILLNESS OF OUTPATIENT TYPE 2 DIABETES MELLITUS IN RURAL VIETNAM: A QUANTILE REGRESSION ANALYSIS FROM THE PATIENT’S PERSPECTIVE
Author(s)
Binh Thang Tran, Sr., MPH, DrPH1, Thi Cam Tu Ngo, Dr, MD, MPH2.
1Lecturer, Hue University, Hue, Viet Nam, 2Public Health, Quang Ngai Provincial Center of Disease Control, Quang Ngai, Viet Nam.
1Lecturer, Hue University, Hue, Viet Nam, 2Public Health, Quang Ngai Provincial Center of Disease Control, Quang Ngai, Viet Nam.
OBJECTIVES: This study aimed to quantify the annual outpatient treatment costs of type 2 diabetes mellitus (T2DM) and identify associated factors across the cost distribution among patients in a rural district of central Vietnam in 2024, from the patient’s perspective.
METHODS: A cross-sectional, prevalence-based cost-of-illness study using a bottom-up micro-costing approach was conducted among 320 T2DM outpatients managed at a primary care medical center, selected by convenience sampling. Direct medical, direct non-medical, and indirect costs were collected through structured interviews and medical record review, and converted to annual costs per patient. Quantile regression models at the 25th, 50th, and 75th percentiles were applied to explore determinants of costs across the distribution.
RESULTS:
The mean annual economic cost was 586.8 ± 492.7 USD per patient, comprising 0.5% direct medical, 88.8% direct non-medical, and 10.7% indirect costs. Functional foods, traditional medicines, and supplements accounted for the majority of direct non-medical expenditure. Quantile regression showed that being female, higher education, and longer disease duration were associated with higher costs at median and/or upper quantiles, while patients treated with oral drugs only incurred significantly lower costs than those using insulin plus oral agents at the 25th and 50th percentiles. Older age groups exhibited increased costs mainly in the upper quantile.
CONCLUSIONS:
Outpatient T2DM imposes a substantial economic burden on rural households, dominated by out-of-pocket direct non-medical payments driven by non-prescribed products. The heterogeneous effects of sociodemographic, clinical, and treatment factors across the cost distribution highlight the need for targeted patient counseling, rational use of adjunctive products, and optimization of treatment strategies in primary care settings in rural Vietnam.
METHODS: A cross-sectional, prevalence-based cost-of-illness study using a bottom-up micro-costing approach was conducted among 320 T2DM outpatients managed at a primary care medical center, selected by convenience sampling. Direct medical, direct non-medical, and indirect costs were collected through structured interviews and medical record review, and converted to annual costs per patient. Quantile regression models at the 25th, 50th, and 75th percentiles were applied to explore determinants of costs across the distribution.
RESULTS:
The mean annual economic cost was 586.8 ± 492.7 USD per patient, comprising 0.5% direct medical, 88.8% direct non-medical, and 10.7% indirect costs. Functional foods, traditional medicines, and supplements accounted for the majority of direct non-medical expenditure. Quantile regression showed that being female, higher education, and longer disease duration were associated with higher costs at median and/or upper quantiles, while patients treated with oral drugs only incurred significantly lower costs than those using insulin plus oral agents at the 25th and 50th percentiles. Older age groups exhibited increased costs mainly in the upper quantile.
CONCLUSIONS:
Outpatient T2DM imposes a substantial economic burden on rural households, dominated by out-of-pocket direct non-medical payments driven by non-prescribed products. The heterogeneous effects of sociodemographic, clinical, and treatment factors across the cost distribution highlight the need for targeted patient counseling, rational use of adjunctive products, and optimization of treatment strategies in primary care settings in rural Vietnam.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EE46
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)