title: Provider costs for prevention and treatment of cardiovascular and related conditions in low- and middle-income countries: a systematic review.
abstract: BACKGROUND
  The burden of cardiovascular disease (CVD) and CVD risk conditions is rapidly increasing in low- and middle-income countries, where health systems are generally ill-equipped to manage chronic disease. Policy makers need an understanding of the magnitude and drivers of the costs of cardiovascular disease related conditions to make decisions on how to allocate limited health resources.
  
  
  METHODS
  We undertook a systematic review of the published literature on provider-incurred costs of treatment for cardiovascular diseases and risk conditions in low- and middle-income countries. Total costs of treatment were inflated to 2012 US dollars for comparability across geographic settings and time periods.
  
  
  RESULTS
  This systematic review identified 60 articles and 143 unit costs for the following conditions: ischemic heart disease, non-ischemic heart diseases, stroke, heart failure, hypertension, diabetes, and chronic kidney disease. Cost data were most readily available in middle-income countries, especially China, India, Brazil, and South Africa. The most common conditions with cost studies were acute ischemic heart disease, type 2 diabetes mellitus, stroke, and hypertension.
  
  
  CONCLUSIONS
  Emerging economies are currently providing a base of cost evidence for NCD treatment that may prove useful to policy-makers in low-income countries. Initial steps to publicly finance disease interventions should take account of costs. The gaps and limitations in the current literature include a lack of standardized reporting as well as sparse evidence from low-income countries.
authors.affiliation: Disease Control Priorities Network, Department of Global Health, University of Washington, 325 Ninth Avenue, Box 259931, Seattle, WA, 98104, USA. ebrouwer@uw.edu.
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Brouwer
authors.affiliation: Department of Medicine, University of Washington, 325 Ninth Ave, Box 359780, Seattle, WA, 98104, USA. davidaw@uw.edu.
authors.forename: David
authors.initials: D
authors.lastname: Watkins
authors.affiliation: School of Public Health, University of California Berkeley, 50 University Hall, #7360, Berkeley, CA, 94720-7360, USA. zolson@berkeley.edu.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Olson
authors.affiliation: PATH, 2201 Westlake Ave #200, Seattle, WA, 98121, USA. jgoett@path.org.
authors.forename: Jane
authors.initials: J
authors.lastname: Goett
authors.affiliation: Disease Control Priorities Network, Department of Global Health, University of Washington, 325 Ninth Avenue, Box 259931, Seattle, WA, 98104, USA. rnugent2@uw.edu.
authors.forename: Rachel
authors.initials: R
authors.lastname: Nugent
authors.affiliation: Disease Control Priorities Network, Department of Global Health, University of Washington, 325 Ninth Avenue, Box 259931, Seattle, WA, 98104, USA. clevin@uw.edu.
authors.forename: Carol
authors.initials: C
authors.lastname: Levin
mesh_terms: D000349:Africa; D001208:Asia; D002318:Cardiovascular Diseases / Q000191:economics* / Q000517:prevention & control / Q000628:therapy; D003906:Developing Countries; D003924:Diabetes Mellitus, Type 2 / Q000191:economics* / Q000517:prevention & control / Q000628:therapy; D005060:Europe; D017048:Health Care Costs; D006296:Health Services / Q000191:economics*; D006801:Humans; D007182:Income; D008877:Middle East; D013020:South America