Arch Iran Med. 2018;21(5): 213-222.
PMID: 29738265
Scopus ID: 85054081819
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Systematic Review

Estimation and Prediction of Avoidable Health Care Costs of Cardiovascular Diseases and Type 2 Diabetes Through Adequate Dairy Food Consumption: A Systematic Review and Micro Simulation Modeling Study

Mehdi Javanbakht 1, Ahmad Reza Jamshidi 2*, Hamid Reza Baradaran 3, Zahra Mohammadi 2, Atefeh Mashayekhi 1, Farhad Shokraneh 4, Mohsen Rezai Hamami 5, Raziyeh Yazdani Bakhsh 6, Hossien Shabaninejad 7, Sajad Delavari 8, Arash Tehrani 3

1 Health Economics Group, Institute of Health & Society, Newcastle University, UK
2 Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
3 Endocrine Research Center , Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Iran
4 Cochrane Schizophrenia Group, University of Nottingham, UK
5 Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, UK
6 Health Information Management, Health Management and Economic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran,
7 Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Iran
8 Health Human Resources Research Center, School of Management & Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
*Corresponding Author: *Corresponding Author: Ahmad Reza Jamshidi, MD; Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Tel: (+98)21-8822- 0065, Fax: (+98)21-8822-0065, Email: , Email: jamshida@tums.ac.ir


Background: Recent evidence from prospective cohort studies show a relationship between consumption of dairy foods and cardiovascular diseases (CVDs) and type 2 diabetes mellitus (T2DM). This association highlights the importance of dairy foods consumption in prevention of these diseases and also reduction of associated healthcare costs. The aim of this study was to estimate avoidable healthcare costs of CVD and T2D through adequate dairy foods consumption in Iran.

Methods: This was a multistage modelling study. We conducted a systematic literature review in PubMed and EMBASE to identify any association between incidence of CVD and T2DM and dairy foods intake, and also associated relative risks. We obtained age- and sex-specific dairy foods consumption level and healthcare expenditures from national surveys and studies. Patient level simulation Markov models were constructed to predict the disease incidence, patient population size and associated healthcare costs for current and optimal dairy foods consumption at different time horizons (1, 5, 10 and 20 years). All parameters including costs and transition probabilities were defined as statistical distributions in the models, and all analyses were conducted by accounting for first and second order uncertainty.

Results: The systematic review results indicated that dairy foods consumption was inversely associated with incidence of T2DM, coronary heart disease (CHD) and stroke. We estimated that the introduction of a diet containing 3 servings of dairy foods per day may produce a $0.43 saving in annual per capita healthcare costs in Iran in the first year due to saving in cost of CVD and T2DM treatment. The estimated savings in per capita healthcare costs were $8.42, $39.97 and $190.25 in 5, 10 and 20-years’ time, respectively. Corresponding total aggregated avoidable costs for the entire Iranian population within the study time horizons were $33.83, $661.31, $3,138.21 and $14,934.63 million, respectively.

Conclusion: Our analysis demonstrated that increasing dairy foods consumption to recommended levels would be associated with reductions in healthcare costs. Further randomized trial studies are required to investigate the effect of dairy foods intake on cost of CVD and T2DM in the population.

Cite this article as: Javanbakht M, Jamshidi AR, Baradaran HR, Mohammadi Z, Mashayekhi A, Shokraneh F, et al. Estimation and prediction of avoidable health care costs of cardiovascular diseases and type 2 diabetes through adequate dairy food consumption: a systematic review and micro simulation modeling study. Arch Iran Med. 2018;21(5):213–222.
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