BACKGROUND: Bipolar Disorder (BD) imposes considerable economic and social burdens on the community. Therefore, the present study aimed to determine the economic burden of bipolar disorder in patients referred to single-specialty psychiatric hospitals at the secondary and tertiary care level in 2022.
METHODS: This partial economic evaluation was conducted as a cross-sectional study in the south of Iran in 2022, and 916 patients were selected through the census method. The prevalence-based and bottom-up approaches were used to collect cost information and calculate the costs, respectively. The data on Direct Medical Costs (DMC), Direct Non-Medical Costs (DNMC), and Indirect costs (IC) were obtained using the information from the patients\' medical records and bills as well as the self-reports by the patients or their companions. The human capital approach was also used to calculate IC.
RESULTS: The results showed that in 2022, the annual cost of bipolar disorder was $4,227 per patient. The largest share of the costs was that of DMC (77.66%), with hoteling and ordinary beds accounting for the highest expenses (55.40%). The shares of DNMC and IC were 6.37% and 15.97%, respectively, and the economic burden of the disease in the country was estimated at $2,799,787,266 as well.
CONCLUSIONS: In general, the costs of bipolar disorder treatment could impose a heavy economic burden on the community, the health system, the insurance system, and the patients themselves. Considering the high costs of hoteling and ordinary beds, it is suggested that hospitalization of BD patients be reduced by managing treatment solutions along with prevention methods to reduce the economic burden of this disease. Furthermore, in order to reduce the costs, proper and fair distribution of psychiatrists and psychiatric beds as well as expansion of home care services and use of the Internet and virtual technologies to follow up the treatment of these patients are recommended.

Indirect costs of animal disease outbreaks often significantly exceed the direct costs. Despite their importance, indirect costs remain poorly characterized due to their complexity. In this study, we developed a framework to assess the indirect costs of a hypothetical African swine fever outbreak in Switzerland. We collected data through international and national stakeholder interviews, analysis of national disease control regulations and industry data. We developed a framework to capture the resulting qualitative and quantitative data, categorize the impacts of these regulations, and rank the impacts in order of importance. We then developed a spreadsheet model to calculate the indirect costs of one category of control measure for an individual group of stakeholders. We developed a decision tree model to guide the most economically favourable implementation plan for a given control measure category, under different outbreak scenarios. Our results suggest that the most important measure/impact categories were \'Transport logistics\', \'Consumer demand\', \'Prevention of wild boar and domestic pig contact\' and \'Slaughter logistics\'. In our hypothetical scenario, the greatest costs associated with \'Prevention of wild boar and domestic pig contact\' were due to assumed partial or total depopulation of fattening pig farms in order to reduce herd size to comply with the simulated control regulations. The model also provides suggestions on the most economically favourable strategy to reduce contact between wild boar and domestic pigs in control areas. Our approach provides a new framework to integrate qualitative and quantitative data to guide disease control strategy. This method could be useful in other countries and for other diseases, including in data- and resource-poor settings, or areas with limited experience of animal disease outbreaks.

Severe malaria due to the infection of Plasmodium falciparum is a critical infection that may lead to multisystem abnormalities if not promptly and adequately treated. We present a case of severe malaria in a patient recently repatriated from Conakry, Guinea, West Africa, marooned during the recent coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). While the direct costs of the SARS-CoV-2 pandemic and its indirect effect on neighboring industries have been analyzed, the indirect costs of other ailments in medicine have yet to be fully established. This case explores the ramifications of the SARS-CoV-2 pandemic on what would otherwise have been routine prophylaxis of malaria in a traveler. Given the pandemic, the healthcare industry has had fundamental changes that have impacted access to healthcare, particularly in the outpatient setting.

BACKGROUND: Growing public and private expenditure on healthcare results i.a. from the spreading of chronic diseases. Diabetes belongs to the most frequent ones, beyond neoplasms and cardiological diseases, and hence generates a significant burden for the public finance in terms of the direct costs. However, the economy suffers also from the indirect cost of diabetes that manifests itself in the loss in Gross Domestic Product (GDP) and general government revenues.
METHODS: This paper aims to measure this indirect cost, both in terms of GDP drop (social perspective) and public revenue drop (public finance perspective), in the case of Poland in 2012-2014. We use a modified human capital approach and unique dataset provided by the Social Security institution in Poland and the Polish Central Statistical Office.
RESULTS: Diabetes is a substantial and growing burden for the Polish economy. In the years 2012, 2013 and 2014 the indirect cost (output loss) amounted to 1.85 bn USD, 1.94 bn USD and 2.00 bn USD respectively.
CONCLUSIONS: Estimated indirect cost of diabetes can be a useful input for health technology analyses of drugs or economic impact assessments of public health programmes.