The impact of seven major noncommunicable diseases on direct medical costs, absenteeism, and presenteeism in Gulf Cooperation Council countries.

Journal Article (Journal Article)


To estimate the current burden of seven major noncommunicable diseases on direct medical costs, absenteeism, and presenteeism in the six countries in the Gulf Cooperation Council: Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates.

Materials and methods

We used data from pre-existing datasets and the literature. We identified seven major noncommunicable diseases for which data were available: coronary heart disease, stroke, type-2 diabetes mellitus, breast cancer, colon cancer, chronic obstructive pulmonary disease, and asthma. We estimated the per unit cost (the annual cost of treating each illness for one person) of each disease, multiplied per unit cost by disease prevalence counts to generate disease-specific costs, and then summed across diseases. We calculated the cost of absenteeism and presenteeism by multiplying the gross domestic product per person in the labor force by the loss in productivity from each disease due to absenteeism and presenteeism, respectively, and the prevalence in the labor force of each disease.


We estimate that the direct medical costs of seven major noncommunicable diseases in Gulf Cooperation Council countries are $16.7 billion (2019 International $), equal to 0.6% of gross domestic product. We estimate that absenteeism and presenteeism due to these seven noncommunicable diseases cost 0.5 and 2.2% of gross domestic product, respectively.


Our study does not capture all noncommunicable diseases and does not capture all types of indirect costs. Our cost estimates are particularly sensitive to our assumptions regarding type-2 diabetes mellitus.


The economic burden of noncommunicable diseases in Gulf Cooperation Council countries is substantial, suggesting that successful preventive interventions have the potential to improve both population health and reduce costs. Further research is needed to capture a broader array of noncommunicable diseases and to develop more precise estimates.

Full Text

Duke Authors

Cited Authors

  • Finkelstein, EA; Malkin, JD; Baid, D; Alqunaibet, A; Mahdi, K; Al-Thani, MBH; Abdulla Bin Belaila, B; Al Nawakhtha, E; Alqahtani, S; El-Saharty, S; Herbst, CH

Published Date

  • January 2021

Published In

Volume / Issue

  • 24 / 1

Start / End Page

  • 828 - 834

PubMed ID

  • 34138664

Electronic International Standard Serial Number (EISSN)

  • 1941-837X

International Standard Serial Number (ISSN)

  • 1369-6998

Digital Object Identifier (DOI)

  • 10.1080/13696998.2021.1945242


  • eng