title: Simple calculator to estimate the medical cost of diabetes in sub-Saharan Africa.
abstract: OBJECTIVE
  To design a medical cost calculator and show that diabetes care is beyond reach of the majority particularly patients with complications.
  
  
  METHODS
  Out-of-pocket expenditures of patients for medical treatment of type-2 diabetes were estimated based on price data collected in Benin, Burkina Faso, Guinea and Mali. A detailed protocol for realistic medical care of diabetes and its complications in the African context was defined. Care components were based on existing guidelines, published data and clinical experience. Prices were obtained in public and private health facilities. The cost calculator used Excel. The cost for basic management of uncomplicated diabetes was calculated per person and per year. Incremental costs were also computed per annum for chronic complications and per episode for acute complications.
  
  
  RESULTS
  Wide variations of estimated care costs were observed among countries and between the public and private healthcare system. The minimum estimated cost for the treatment of uncomplicated diabetes (in the public sector) would amount to 21%-34% of the country's gross national income per capita, 26%-47% in the presence of retinopathy, and above 70% for nephropathy, the most expensive complication.
  
  
  CONCLUSIONS
  The study provided objective evidence for the exorbitant medical cost of diabetes considering that no medical insurance is available in the study countries. Although the calculator only estimates the cost of inaction, it is innovative and of interest for several stakeholders.
authors.affiliation: Koffi Alouki, Hélène Delisle, Department of Nutrition, Faculty of Medicine, University of Montreal, Downtown Station, Montreal H3C 3J7, QC, Canada.
authors.forename: Koffi
authors.initials: K
authors.lastname: Alouki
authors.affiliation: Koffi Alouki, Hélène Delisle, Department of Nutrition, Faculty of Medicine, University of Montreal, Downtown Station, Montreal H3C 3J7, QC, Canada.
authors.forename: Hélène
authors.initials: H
authors.lastname: Delisle
authors.affiliation: Koffi Alouki, Hélène Delisle, Department of Nutrition, Faculty of Medicine, University of Montreal, Downtown Station, Montreal H3C 3J7, QC, Canada.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Besançon
authors.affiliation: Koffi Alouki, Hélène Delisle, Department of Nutrition, Faculty of Medicine, University of Montreal, Downtown Station, Montreal H3C 3J7, QC, Canada.
authors.forename: Naby
authors.initials: N
authors.lastname: Baldé
authors.affiliation: Koffi Alouki, Hélène Delisle, Department of Nutrition, Faculty of Medicine, University of Montreal, Downtown Station, Montreal H3C 3J7, QC, Canada.
authors.forename: Assa
authors.initials: A
authors.lastname: Sidibé-Traoré
authors.affiliation: Koffi Alouki, Hélène Delisle, Department of Nutrition, Faculty of Medicine, University of Montreal, Downtown Station, Montreal H3C 3J7, QC, Canada.
authors.forename: Joseph
authors.initials: J
authors.lastname: Drabo
authors.affiliation: Koffi Alouki, Hélène Delisle, Department of Nutrition, Faculty of Medicine, University of Montreal, Downtown Station, Montreal H3C 3J7, QC, Canada.
authors.forename: François
authors.initials: F
authors.lastname: Djrolo
authors.affiliation: Koffi Alouki, Hélène Delisle, Department of Nutrition, Faculty of Medicine, University of Montreal, Downtown Station, Montreal H3C 3J7, QC, Canada.
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Mbanya
authors.affiliation: Koffi Alouki, Hélène Delisle, Department of Nutrition, Faculty of Medicine, University of Montreal, Downtown Station, Montreal H3C 3J7, QC, Canada.
authors.forename: Serge
authors.initials: S
authors.lastname: Halimi
keywords: Advocacy; Africa; Cost-of-illness; Diabetes; Non-communicable diseases