Economics of Specific Diseases

Economics of Specific Diseases

Introduction

·       Health economics studies not only general systems but also the economic implications of specific diseases and health behaviors.

·       Diseases and health choices affect productivity, labor markets, health expenditure, insurance costs, and broader societal welfare.

Economic Aspects of Breastfeeding

• Health Benefits:
• Reduces infant mortality and morbidity (diarrhea, pneumonia, malnutrition).
• Protects mothers from breast and ovarian cancers, type 2 diabetes.
• Economic Benefits:
• Direct cost savings: Less spending on infant formula, reduced hospitalizations.
• Reduced healthcare costs: WHO estimates optimal breastfeeding could save $300 billion annually worldwide due to lower treatment costs and improved cognition.
• Productivity gains: Breastfed children have higher IQ and educational outcomes → higher lifetime earnings.
• Policy/Program Implications:
• Investment in maternity leave, breastfeeding-friendly workplaces, lactation counseling yields high return on investment (ROI).
• Barriers: Short maternity leave, aggressive marketing by formula companies, lack of workplace support.

Economic Aspects of Alcohol Abuse

• Individual Level:
• Increased medical costs: liver disease, cancers, accidents, mental health disorders.
• Loss of productivity due to absenteeism, presenteeism, unemployment.
• Societal Level:
• Social costs: Road traffic accidents, violence, family disruption, law enforcement burden.
• World Bank estimates alcohol-related harm accounts for 1–2% of GDP in many countries.
• Health System Costs:
• Long-term treatment for cirrhosis, cardiovascular disease, psychiatric care.
• Policy/Intervention Economics:
• Cost-effective strategies: taxation, limiting alcohol advertising, minimum drinking age enforcement.
• Evidence shows alcohol taxation reduces consumption, generates government revenue, and saves treatment costs.

Economic Aspects of Smoking

• Healthcare Costs:
• Smoking-related illnesses (lung cancer, COPD, CVD) account for billions in healthcare costs globally.
• In India, tobacco use causes an estimated ₹1,82,000 crore annual economic loss (treatment + productivity loss).
• Productivity Loss:
• Early deaths → reduced labor force participation.
• Sick leave, lower work efficiency.
• Social Costs:
• Passive smoking burden on non-smokers (children, family).
• Economic Policies:
• Excise taxes on tobacco: proven cost-effective (reduces demand, increases revenue).
• Anti-smoking campaigns & cessation support: reduce long-term treatment burden.
• WHO’s MPOWER framework emphasizes price increase, smoke-free laws, advertising bans, education.

Economic Aspects of Disease Prevention

• Prevention vs Treatment:
• Preventive care (vaccinations, screening, lifestyle changes) generally more cost-effective than curative care.
• Example: Polio vaccination is far cheaper than treating paralysis and lifelong disability.
• Economic Returns:
• WHO estimates every $1 invested in prevention saves up to $14 in treatment costs.
• Types of Prevention:
• Primary: Immunization, sanitation, health education.
• Secondary: Screening for cancers, hypertension, diabetes.
• Tertiary: Rehabilitation to reduce disability.
• Challenges:
• Preventive investments often politically less attractive (benefits seen long-term).
• Requires cross-sectoral investment (education, nutrition, housing).

Economic Aspects of HIV/AIDS

• Burden on Health Systems:
• High treatment costs (lifelong ART therapy).
• Opportunistic infection management (TB, fungal infections).
• Labor Market Impact:
• Reduced productivity due to illness.
• Loss of workforce in prime working age (15–49 years).
• Stigma and discrimination reduce employability.
• Household Economics:
• Catastrophic out-of-pocket expenditure, orphaned children, loss of breadwinner.
• Macro-Economic Impact:
• In high-prevalence countries, HIV reduces GDP growth (due to loss of human capital).
• Intervention Economics:
• Cost-effective interventions: prevention of mother-to-child transmission, condom promotion, needle exchange programs.
• ART is costly but highly cost-effective in reducing transmission, prolonging life, and maintaining productivity.

Economic Aspects of Malaria

• Direct Costs:
• Expenditure on treatment, hospitalization, prevention (bed nets, insecticides).
• Indirect Costs:
• Loss of productivity due to absenteeism, chronic anemia, cognitive impairment in children.
• Agricultural losses in endemic areas (farmers unable to work during peak transmission).
• National Economic Burden:
• Malaria-endemic countries lose ~1.3% of GDP annually.
• Prevention Economics:
• Insecticide-treated bed nets (ITNs) and indoor residual spraying (IRS) are highly cost-effective.
• Early diagnosis and treatment reduce long-term disability and transmission.
• Investment Returns:
• World Bank estimates malaria control yields a 20:1 return on investment in Sub-Saharan Africa.

Economic Aspects of Cancer

• Healthcare Costs:
• High direct costs: diagnosis (imaging, biopsy), surgery, chemotherapy, radiation, palliative care.
• Long-term care burden on families and insurance systems.
• Productivity Loss:
• High premature mortality in working-age adults.
• Survivors may face reduced earning capacity due to treatment side effects.
• Household Catastrophic Expenditure:
• In LMICs (like India), many families fall into poverty due to cancer treatment costs.
• Prevention & Screening Economics:
• Tobacco control, HPV vaccination, and screening (breast, cervical, colorectal) are cost-effective and reduce long-term cancer burden.
• Policy Aspects:
• Need for universal health coverage (UHC) and insurance to prevent financial catastrophe.
• Investment in palliative care reduces hospital costs and improves quality of life.

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