Estimating the economic burden of stroke in Iran: evidence from a cost-of-illness study
8 affiliations
- 1Department of Health Information Technology, Ferdows Faculty of Medical Sciences, Birjand University of Medical Sciences, Birjand, Iran
- 2Social determinants of health research center, Birjand University of Medical Sciences, Birjand, Iran
- 3Department of Health Policy, Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- 4National Center for Health Insurance Research, Tehran, Iran
- 5Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, 1417613151 Iran
- 6Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
- 7Department of Neurology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- 8Neuro interventionist Shariati Hospital, Tehran, Iran
Abstract
Background: Stroke imposes a substantial economic burden worldwide. This study estimated the total economic burden of stroke in Iran in 2020 by examining direct, indirect, and intangible cost components.
Methods: A prevalence-based cost-of-illness approach was applied from a societal perspective. To enhance accuracy, direct outpatient costs were estimated through a one-year follow-up of stroke patients to minimize recall bias. Indirect costs—comprising productivity losses (estimated using the Human Capital Approach) and informal care costs (estimated using a mixed method combining the proxy good and opportunity cost approaches)—were calculated alongside intangible costs reflecting losses in health-related quality of life to address gaps in previous studies.
Results: The total economic burden of stroke in Iran in 2020 was US$1,424.92 million (equivalent to US$PPP 12,809.32 million). Direct medical costs accounted for US$509.44 million, direct nonmedical costs for US$128.08 million, intangible costs for US$501.87 million, and productivity losses for US$285.52 million. The per-capita cost of stroke in Iran was approximately one-sixth of the global per-capita estimate.
Conclusion: These findings highlight the need to address social determinants of health and ensure equitable access to high-quality care, particularly for individuals with low socioeconomic status. Given the rising incidence of stroke among adults aged 25 and older, comprehensive prevention strategies and lifestyle interventions are essential to reduce the future economic burden.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12889-026-28747-6.
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BibTeX
@article{kazemi2026estimating,
title = {{Estimating the economic burden of stroke in Iran: evidence from a cost-of-illness study}},
author = {Zohreh Kazemi and Rajabali Daroudi and Mohammad Sadegh Hassanvand and Askar Ghorbani and Sara Emamgholipour Sefiddashti and Masud Yunesian},
journal = {BMC Public Health},
year = {2026},
month = aug,
doi = {10.1186/s12889-026-28747-6},
url = {https://doi.org/10.1186/s12889-026-28747-6},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Estimating the economic burden of stroke in Iran: evidence from a cost-of-illness study
AU - Zohreh Kazemi
AU - Rajabali Daroudi
AU - Mohammad Sadegh Hassanvand
AU - Askar Ghorbani
AU - Sara Emamgholipour Sefiddashti
AU - Masud Yunesian
PY - 2026
DA - 2026/08/07
JO - BMC Public Health
DO - 10.1186/s12889-026-28747-6
UR - https://doi.org/10.1186/s12889-026-28747-6
AB - Background: Stroke imposes a substantial economic burden worldwide. This study estimated the total economic burden of stroke in Iran in 2020 by examining direct, indirect, and intangible cost components. Methods: A prevalence-based cost-of-illness approach was applied from a societal perspective. To enhance accuracy, direct outpatient costs were estimated through a one-year follow-up of stroke patients to minimize recall bias. Indirect costs—comprising productivity losses (estimated using the Human Capital Approach) and informal care costs (estimated using a mixed method combining the proxy good and opportunity cost approaches)—were calculated alongside intangible costs reflecting losses in health-related quality of life to address gaps in previous studies. Results: The total economic burden of stroke in Iran in 2020 was US$1,424.92 million (equivalent to US$PPP 12,809.32 million). Direct medical costs accounted for US$509.44 million, direct nonmedical costs for US$128.08 million, intangible costs for US$501.87 million, and productivity losses for US$285.52 million. The per-capita cost of stroke in Iran was approximately one-sixth of the global per-capita estimate. Conclusion: These findings highlight the need to address social determinants of health and ensure equitable access to high-quality care, particularly for individuals with low socioeconomic status. Given the rising incidence of stroke among adults aged 25 and older, comprehensive prevention strategies and lifestyle interventions are essential to reduce the future economic burden. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12889-026-28747-6.
SN - 1471-2458
ER -