The Health Economics Unit of the Directorate General of Health Services under the Ministry of Health & Family Welfare of Bangladesh reports that out-of-pocket health expenditure in the country has been on the rise, reaching around 69 per cent in 2020. This has raised concerns among public health experts, policymakers, and healthcare professionals. Pharmaceuticals account for a significant portion of patients’ total health expenses, while ambulatory medical service providers and medical and diagnostic facilities also contribute to out-of-pocket payments. The high out-of-pocket health expenditure is further exacerbated by the recent increase in the cost of necessities and the general economic downturn. It is emphasized that delaying medical attention due to financial constraints can lead to deteriorating health conditions and increased healthcare costs over time.
The term “out-of-pocket health expenses” encompasses costs that individuals bear for medical services, treatments, and prescription drugs that are not covered by the government, private insurance, or other third parties. Non-medical costs associated with seeking healthcare, such as lost wages, time, and productivity, are often not considered in economic burden assessments, although they significantly impact individuals and families. There are three types of health expenses related to a disease or illness: direct medical, direct non-medical, and indirect costs. Direct medical costs include expenses related to healthcare resource utilization, while direct non-medical costs encompass transportation-related expenses and caregiver expenses. Indirect costs cover lost work productivity and lifetime productivity of patients, family, or caregivers.
Understanding and documenting all expenses incurred by the healthcare system, patients, and society is essential. Public health programme evaluations and economic burdens should encompass the full range of costs, including non-medical expenses, to provide a comprehensive understanding of the impact of healthcare costs on individuals and society. Efforts are needed to address the rising out-of-pocket health expenditure in Bangladesh and work towards achieving the goals outlined in the “Health Care Financing Strategy 2012-32.”
