Cost of Illness Study: Cushing's Syndrome in the Kingdom of Saudi Arabia
Author(s)
Wael Almistehi, MD1, Aishah Ekhzaimy, MD2, Awad Alshahrani, MD3, Yasser Albarkah, PhD4, Mohammed Alshraim, MSc5, ABUBKER OMAER, BSc. Pharmacology, Pharm. D6, Abdulmohsin Marghalani, MBA, MSc, RPh7, Abdulaziz Alaqil, PharmD8, Hossam Magdy, MSc9, Shaima Khader, MSc10, Muhannad Alharbi, MSc10.
1Obesity, Endocrine, and Metabolism Center, King Fahad Medical City, Second Health Care Cluster, Riyadh, Saudi Arabia, 2King Khaled University Hospital, Riyadh, Saudi Arabia, 3Ministry of National Guard – Health affairs, Riyadh, Saudi Arabia, 4Ministry of Defense and Aviation, Riyadh, Saudi Arabia, 5Ministry of National Guard -Health Affairs, Riyadh, Saudi Arabia, 6National Unified Procurement Company, Riyadh, Saudi Arabia, 7King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia, 8King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia, 9Recordati Rare Disease Company, Dubai, United Arab Emirates, 10HEPA Solutions, Riyadh, Saudi Arabia.
1Obesity, Endocrine, and Metabolism Center, King Fahad Medical City, Second Health Care Cluster, Riyadh, Saudi Arabia, 2King Khaled University Hospital, Riyadh, Saudi Arabia, 3Ministry of National Guard – Health affairs, Riyadh, Saudi Arabia, 4Ministry of Defense and Aviation, Riyadh, Saudi Arabia, 5Ministry of National Guard -Health Affairs, Riyadh, Saudi Arabia, 6National Unified Procurement Company, Riyadh, Saudi Arabia, 7King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia, 8King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia, 9Recordati Rare Disease Company, Dubai, United Arab Emirates, 10HEPA Solutions, Riyadh, Saudi Arabia.
OBJECTIVES: Cushing’s syndrome is a rare yet debilitating endocrine disorder caused by chronic exposure to elevated cortisol levels. It is associated with considerable clinical complications, reduced quality of life, and increased healthcare resource utilization. Despite these burdens, data on the economic impact of Cushing’s syndrome in the Kingdom of Saudi Arabia (KSA) remain limited.This study aims to estimate the economic burden of Cushing’s syndrome in Saudi Arabia from both public healthcare payer and societal perspectives, considering both controlled and uncontrolled disease states.
METHODS: A prevalence-based cost-of-illness model was developed over a 1- to 5-year horizon in Saudi Arabia. Disease prevalence and cost inputs were collected through expert consultation at six tertiary care centers, national drug procurement references, and peer-reviewed sources. The model adopted a bottom-up costing approach to quantify direct medical costs (e.g., consultations, diagnostics, pharmacological therapy, surgeries) and indirect costs (e.g., productivity losses from work absenteeism). The analysis accounted for disease transitions and categorized patients into controlled and uncontrolled groups.
RESULTS: The estimated national prevalence rate of Cushing’s syndrome in KSA was 0.0057%, with 56.7% presenting as uncontrolled cases. Annual per-patient costs were SAR 88,137 for controlled and SAR 199,587 for uncontrolled cases. Over five years, cumulative costs per patient increased to SAR 440,685 and SAR 663,585 among diseases transitions cases. Indirect costs constituted 26% to 34.5% of total costs based on Cushing’s syndrome cases. Extrapolating these findings nationally, the projected total 5-year economic burden ranges from SAR 238.4 million to SAR 359 million based on disease state transitions.
CONCLUSIONS: Cushing’s syndrome imposes a significant and escalating economic burden in Saudi Arabia, particularly among uncontrolled patients. These findings underscore the importance of early diagnosis, optimized management strategies, and targeted access policies to reduce long-term health and financial consequences.
METHODS: A prevalence-based cost-of-illness model was developed over a 1- to 5-year horizon in Saudi Arabia. Disease prevalence and cost inputs were collected through expert consultation at six tertiary care centers, national drug procurement references, and peer-reviewed sources. The model adopted a bottom-up costing approach to quantify direct medical costs (e.g., consultations, diagnostics, pharmacological therapy, surgeries) and indirect costs (e.g., productivity losses from work absenteeism). The analysis accounted for disease transitions and categorized patients into controlled and uncontrolled groups.
RESULTS: The estimated national prevalence rate of Cushing’s syndrome in KSA was 0.0057%, with 56.7% presenting as uncontrolled cases. Annual per-patient costs were SAR 88,137 for controlled and SAR 199,587 for uncontrolled cases. Over five years, cumulative costs per patient increased to SAR 440,685 and SAR 663,585 among diseases transitions cases. Indirect costs constituted 26% to 34.5% of total costs based on Cushing’s syndrome cases. Extrapolating these findings nationally, the projected total 5-year economic burden ranges from SAR 238.4 million to SAR 359 million based on disease state transitions.
CONCLUSIONS: Cushing’s syndrome imposes a significant and escalating economic burden in Saudi Arabia, particularly among uncontrolled patients. These findings underscore the importance of early diagnosis, optimized management strategies, and targeted access policies to reduce long-term health and financial consequences.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE181
Topic
Economic Evaluation, Epidemiology & Public Health, Health Policy & Regulatory
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity), No Additional Disease & Conditions/Specialized Treatment Areas, Rare & Orphan Diseases