Cost burden of type 2 diabetes mellitus (DM) in an urban area of Bangladesh: A hospital-based mix method study

Background Longtime treatment of diabetic patients is an added burden for countries that had low GDP and no health insurance facilities like Bangladesh. Urgent cost assessment and proper strategy needs to be developed to overcome the economic burden of a diabetic patient. Methodology We have conducted a mixed-methods study in a Bangladesh Institute of Health Sciences (BIHS), a sister concern of BIRDEM hospital between August 2019 to January 2020. Quantitative data was collected by a survey questionnaire from the patients and qualitative data was collected by interviewing five key informants of the facility center. Results 329 known diabetic patients were enrolled, out of the 70.48% were female and the rest of them were male. The mean age of the respondents was 53.73 years. Nearly 35% of them had a positive family history, and more than 30% of them had both hypertension and dyslipidemia along with DM. The total average cost per year was ∼600USD, which includes drug, investigation, consultancy & transportation costs. Among which drug costs were the most (∼350 USD).We had found that drug cost & investigation cost had a significant associated with increased age, level of education, and the duration of DM. Investigation cost was also associated with positive family history. Conclusions As there is no insurance coverage in Bangladesh and subsidy are not available, many of the patients from the lower socio-economic group might discontinue the treatment. Further prospective research is needed to develop a proper guideline for policymakers. Strength & Limitation ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement It was an unfunded research work ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethical clearance was taken from ethical review committee of American Internation University-Bangladesh All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes Data is available on reasonable request