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Background <p>Type 2 Diabetes (T2D) is rapidly increasing in Sub-Saharan Africa (SSA), with related health and financial implications. Knowledge of the costs and cost-effectiveness of managing diabetes is needed to increase awareness, improve resource allocation and enhance the use of evidence-based decision-making. Accordingly, this study sought to synthesise and critically review evidence on the costs and cost-effectiveness of managing T2D in Sub-Saharan Africa (SSA).</p> Methods <p>A systematic search was conducted in multiple databases, including PubMed-Medline, Africa-Wide Information, Web of Science, Cochrane Library, CINAHL, Scopus, and Google Scholar, to identify studies published between January 2010 and December 2023; the searches were updated in June 2024. All cost data were converted to 2024 United States dollars (US$) using appropriate inflation adjustments and exchange rates. The review protocol was registered with PROSPERO (CRD42022300580).</p> Results <p>The search yielded 4137 unique abstracts, and 18 studies were included for review, most originating from Nigeria. Most studies assessed costs from a provider perspective, focusing on direct medical costs (e.g., outpatient consultations, medications, diagnostic and monitoring tests, and follow-up care). Reported costs of T2D management were substantial across settings. Annual costs ranged from US$337.50 for basic medical care of uncomplicated T2D to US$2330.74 in total provider cost per patient. The highest burden was reported among individuals in the low-income quantile. Only five studies assessed cost-effectiveness, most using modelling and simulation approaches. T2D management programmes can be cost-effective, but the evidence remains limited.</p> Conclusions <p>This review identified substantial variation in methods, perspectives, and cost components across T2D cost studies in SSA, which limits direct comparability. Improving methodological transparency and reporting, alongside addressing data-collection gaps, would strengthen the evidence base. Further context-specific economic evaluations, particularly those incorporating affordability, implementation feasibility, and budget impact, are needed to support priority setting and resource allocation for T2D management in SSA.</p>

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Costs and cost-effectiveness of type 2 diabetes management in Sub-Saharan Africa: a systematic review

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月22日

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  • Assegid Hellebo,
  • Andre P. Kengne,
  • Olufunke A. Alaba

摘要

Background

Type 2 Diabetes (T2D) is rapidly increasing in Sub-Saharan Africa (SSA), with related health and financial implications. Knowledge of the costs and cost-effectiveness of managing diabetes is needed to increase awareness, improve resource allocation and enhance the use of evidence-based decision-making. Accordingly, this study sought to synthesise and critically review evidence on the costs and cost-effectiveness of managing T2D in Sub-Saharan Africa (SSA).

Methods

A systematic search was conducted in multiple databases, including PubMed-Medline, Africa-Wide Information, Web of Science, Cochrane Library, CINAHL, Scopus, and Google Scholar, to identify studies published between January 2010 and December 2023; the searches were updated in June 2024. All cost data were converted to 2024 United States dollars (US$) using appropriate inflation adjustments and exchange rates. The review protocol was registered with PROSPERO (CRD42022300580).

Results

The search yielded 4137 unique abstracts, and 18 studies were included for review, most originating from Nigeria. Most studies assessed costs from a provider perspective, focusing on direct medical costs (e.g., outpatient consultations, medications, diagnostic and monitoring tests, and follow-up care). Reported costs of T2D management were substantial across settings. Annual costs ranged from US$337.50 for basic medical care of uncomplicated T2D to US$2330.74 in total provider cost per patient. The highest burden was reported among individuals in the low-income quantile. Only five studies assessed cost-effectiveness, most using modelling and simulation approaches. T2D management programmes can be cost-effective, but the evidence remains limited.

Conclusions

This review identified substantial variation in methods, perspectives, and cost components across T2D cost studies in SSA, which limits direct comparability. Improving methodological transparency and reporting, alongside addressing data-collection gaps, would strengthen the evidence base. Further context-specific economic evaluations, particularly those incorporating affordability, implementation feasibility, and budget impact, are needed to support priority setting and resource allocation for T2D management in SSA.