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Economic Studies on Non-Communicable Diseases and Injuries in India: A Systematic Review

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Abstract

Background

The burden from non-communicable diseases and injuries (NCDI) in India is increasing rapidly. With low public sector investment in the health sector generally, and a high financial burden on households for treatment, it is important that economic evidence is used to set priorities in the context of NCDI.

Objective

Our objective was to understand the extent to which economic analysis has been used in India to (1) analyze the impact of NCDI and (2) evaluate prevention and treatment interventions. Specifically, this analysis focused on the type of economic analysis used, disease categories, funding patterns, authorship, and author characteristics.

Methods

We conducted a systematic review based on economic keywords to identify studies on NCDI in India published in English between January 2006 and November 2016. In all, 96 studies were included in the review. The analysis used descriptive statistics, including frequencies and percentages.

Results

A majority of the studies were economic impact studies, followed by economic evaluation studies, especially cost-effectiveness analysis. In the costing/partial economic evaluation category, most were cost-description and cost-analysis studies. Under the economic impact/economic burden category, most studies investigated out-of-pocket spending. The studies were mostly on cardiovascular disease, diabetes, and neoplasms. Slightly over half of the studies were funded, with funding coming mainly from outside of India. Half of the studies were led by domestic authors. In most of the studies, the lead author was a clinician or a public health professional; however, most of the economist-led studies were by authors from outside India.

Conclusions

The results indicate the lack of engagement of economists generally and health economists in particular in research on NCDI in India. Demand from health policy makers for evidence-based decision making appears to be lacking, which in turn solidifies the divergence between economics and health policy, and highlights the need to prioritize scarce resources based on evidence regarding what works. Capacity building in health economics needs focus, and the government’s support in this is recommended.

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Acknowledgements

The authors are grateful to Doctors for You for providing a platform to present early results. We acknowledge Nobhojit Roy, Siddarth David, and Kapil Dev Soni for their support and suggestions. We are indebted to Avantika Ranjan for helping us finalize some of the editorial aspects of the manuscript.

Data availability statement

The data that support the findings of this review were generated after examining full-text articles obtained through PubMed. In a few cases, PubMed did not provide full text articles but only a title and an abstract.  In such cases, the articles were located using Sciencedirect, Google Scholar, Karolinska Institute Library (https://kib.ki.se/en), and individual requests to authors. These data are available from the corresponding author, Indrani Gupta, upon reasonable request. Copyright restrictions mean we are unable to provide the full text of any of the articles included in the review.

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  1. Institute of Economic Growth, University of Delhi Enclave, Delhi, 110007, India

    Indrani Gupta & Arjun Roy

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  1. Indrani Gupta
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  2. Arjun Roy
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Contributions

IG identified research questions, defined exclusion and inclusion criteria, and selected studies based on the criteria. AR searched for and selected studies based on selection criteria, extracted data from the studies, and drew up relevant tables. Both authors analyzed the data and wrote the manuscript.

Corresponding author

Correspondence to Indrani Gupta.

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No funding was received for this research.

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The authors Indrani Gupta and Arjun Roy have no conflicts of interest to declare.

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Gupta, I., Roy, A. Economic Studies on Non-Communicable Diseases and Injuries in India: A Systematic Review. Appl Health Econ Health Policy 16, 303–315 (2018). https://doi.org/10.1007/s40258-018-0370-1

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