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Iran J Public Health. 2015 Apr;44(4):512-21.

The Economic Burden of Liver Cirrhosis in Iran: a Cost of Illness Study.

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Dept. of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Research Center for Gastroenterology and Liver Disease, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Vice Chancellery of Treatment, Qazvin University of Medical Sciences, Qazvin, Iran.
Dept. of Public Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.



According to importance of cirrhosis of the liver and the lack of information about the economic burden of the disease, we performed this study to estimate the economic burden of liver Cirrhosis in Iran in 2011.


The cost-of-illness method, based on the human capital theory, has been used. Both direct and indirect costs have been estimated using a prevalence approach and bottom-up method. The inpatient and outpatient records were investigated for obtaining the medical costs. Also, a questionnaire was used for collection the other data such as transportation costs, out of pocket payment and times of inpatients, etc. Costs consisted of expenditures which happened during March 2011 to February 2012 and the perspective of the study was Iranian society.


The total cost of the disease was 2014.5 billion Rials (USD164.32 million). Direct and indirect costs were 1384.16 and 630.4 billion Rials (86.7% and 11.3% of the total cost), respectively. Cost due to premature death was USD 38.66 million, included 23.52% of the total cost and 75% of indirect cost.


Liver Cirrhosis impose enormous economic burden on Iranian society. Policymakers should therefore take this into consideration and according to available health resources provide services and facilities for the prevention and treatment of the disease.


Cost of illness; Economic burden; Iran; Liver cirrhosis; Out of pocket payments


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