Noncommunicable diseases cost Malaysia $2.17b in healthcare

Diabetes made up the largest share of healthcare costs.

The direct healthcare costs of non-communicable diseases—namely cardiovascular disease (CVD), diabetes and cancer—in Malaysia reached $2.17b (RM9.65b) or $67.81 (RM301.37) per capita in one year, according to a new report from the country’s Ministry of Health.

In a government-led study based on 2017 data on public hospitals, diabetes made up nearly half or 45.38% of the total costs at nearly $1b (RM4.38b). It is followed by cardiovascular diseases and cancer at $884.24m (RM3.93b), and cancer at $301.5m (RM1.34b).

The report noted that the economic burden of the diseases is expected to worsen over time given the country’s ageing population.

“Noncommunicable diseases (NCDs) are the main cause of death and disability in Malaysia. Their growing prevalence is placing increased strain on the country’s health system through a rising demand for health services,” the report stated.

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The higher costs of diabetes compared to cardiovascular disease were mainly attributed to the high proportion of primary care and outpatient attendances attributable to diabetes. The inclusion of tests for heart disease is limited to routine diagnostic and monitoring tests delivered in an outpatient setting to high-risk adults also factored in.

“It was assumed that more complex and costly tests such as echocardiogram, coronary angiogram, etc. were primarily performed in the inpatient setting and would be captured in the hospitalization costs,” the report added.

Hospitalization costs made up 16.33% of total costs for the three categories. The report noted that the hospitalization costs for diabetes were low, but they expect that many patients admitted with a principal diagnosis of cardiovascular disease would have diabetes as comorbidity, as it is a common precursor to a cardiac event.

Instead, primary care consultations made up the largest portion of the costs at $944.99m (RM4.2b), or 43.38% of total costs. Diabetes accounted for by far the largest proportion of these costs at 70.56%, whilst cancer accounted for only 6.57%.

Moreover, $387m (RM1.72b) was expended on medications for the diseases. Nearly half or 46% of this expenditure was incurred for drugs for patients with cardiovascular diseases, whilst the balance was distributed between drugs for diabetes (30.33%) and cancer (23.67%).

Expenditures on medical tests totalled $375.75m (RM1.67b), with cardiovascular disease patients accounting for the largest share of this expenditure.

While the cost estimates are based on the best available date, they no doubt underestimate the real cost of the direct health-care costs associated with NCDs in Malaysia.