Government's Pharmaceutical Health Budget Receiving Pressure from High Blood Pressure and Diabetes
By Liisa Vexler
The prevalence of non-communicable diseases (NCDs) in the Pacific is creating particular challenges to health, finance and policy in the region of Vanuatu and surrounding countries. The NCDs of particular concern are type 2 diabetes and cardiovascular disease/hypertension. NCDs are believed to be responsible for deaths in a large proportion of the Pacific population, with percentages as high as 70% and rates of premature death much higher in the Pacific than in equivalent low-income countries worldwide.
The budget implications of these percentages are significant, as they place added pressure on the government due to the emphasis on government funded care instead of private health insurance. The financial burden of these specific NCDs is considered unsustainable for the pharmaceutical/health budget in Vanuatu.
It is clear from analysis of costs involved in treating these NCDs as they advance in severity that costs increase significantly. This is evident where a patient moves from simple blood glucose testing to required first stage medication. In this particular case, costs increase from US$5.59 to US$24.55—a four-fold increase. The increase then escalates to a 15-fold equivalent once drugs such as insulin are required. The picture is similar for costs related to hypertension, with 12-fold increases as the patient transitions from initial medication to advanced drug therapy.
These figures do not incorporate additional costs to the government from salaries, hospital care and equipment. These financial pressures mean that a typical patient in Vanuatu who requires insulin will exhaust a budget normally allocated to 76 citizens. This is a significant challenge where there is a prevalence rate of 22% in Vanuatu for diabetes alone (age 20 to 79 years).
An important policy priority for Vanuatu is prevention of diabetes and hypertension. Through preventive lifestyle interventions for diabetes, US$367 per capita could be saved annually. A relative equivalent savings applies as well in the case of hypertension.