COMPARATIVE ANALYSIS OF APPROPRIATE AND COST EFFECTIVE SYSTEM OF TREATMENT FOR DIABETES AND HYPERTENSION DURING COVID-19
Authors:   Doctor of Letters in Management [Public Health], Singhania University, Pacheri Bari, Jhunjhunu, Rajasthan, India., Vashist Naresh 
Published: June 2024

Background:Traditional herbal healthcare system is commonly used for diabetes and hypertension due to the reason that modern allopathic system is more expensive comparatively and the costs of healthcare and prescription drugs rapidly increasing each year.About 80% of the world populations of developing countries rely on this traditional herbal healthcare system of medicine.High health and medical expenditure has heavy economic burden on government which requires a way to restrain its growth.Out of pocket expenses for health services in India are 85% and about 20% of the patients in the OPDs, nationwide, prefer to go to the private hospitals despite higher out of pocket payments.The combined Union expenditure on health sector is 1.18% of GDP whereas economic survey shows it as 2.1% of GDP in 2022-23, 2.2% in 202-22, 1.6% in 2020-21.India is lagging far behind to reach this target of expenditure of health budget. â‚¹ 14,217 crore was spent for COVID-19 emergency response and health system preparedness package and COVID-19 vaccination for healthcare and frontline workers.Cumulative Foreign Direct Investment [FDI] equity inflow into drug and pharmaceutical industries in India from 2000 to December 2022 was US$ 22 billion which is projected to US$ 130 billion by December 2030.FDI is reached US$ 1414 million in financial year 2021-22 in drugs and pharmaceutical sector. Diabetes and hypertension have been identified as risk factors and prognostic for severe COVID-19. Annually, 12% high inflation is projected to rise on healthcare. Diabetes and hypertension are increasing in low and middle income countries which is approximately 722 million adults worldwide and 892 million by 2035.67.0% of the healthcare spending of Indians is on medicine alone whereas 33.0% is for other serves payments. There are large financial differences in capital structure position of pharmaceutical firms. Therefore the cost of medicines in pharmaceutical market, corporate uses of capital must be bench marked against these capital market alternatives.Public expenditure on healthcare in India, stood at 2.1% of GDP in 2021-22 against 1.8% in 2020-21 and 1.3% in 2019-20.. Indian Healthcare sector is contributing 6% to the GDP of the country and becoming fast-growing service sector. Indiaâ€™s health system faces the ongoing challenge of responding to the needs of the most disadvantaged members of Indian society. Despite progress in improving access to health care, inequalities by socioeconomic status, geography and gender continue to persist. This is compounded by high out-of-pocket expenditures, with the rising financial burden of health care falling overwhelming on private households, which account for more than three-quarter of health spending in India. Health expenditures are responsible for more than half of Indian households falling into poverty; the impact of this has been increasing pushing around 39 million Indians into poverty each year. In this paper, we identify key challenges to equity in service delivery, and equity in financing and financial risk protection in India. These include imbalanced resource allocation, limited physical access to quality health services and inadequate human resources for health; high out-of-pocket health expenditures, health spending inflation, and behavioral factors that affect the demand for appropriate health care. Complementing other paper in this Series, we argue for the application of certain principles in the pursuit of equity in health care in India. These are the adoption of equity metrics in monitoring, evaluation and strategic planning, investment in developing a rigorous knowledge-base of health systems research; development of more equity-focused process of deliberative decision-making in health reform, and redefinition of the specific responsibilities and accountabilities of key actors. The implementation of these principles, together with strengthening of public health and primary care services, provide an approach for ensuring more equitable health care for Indiaâ€™s populThe global diabetes and hypertension prevalence in 2019 is estimated to be 12.3% (722 million people), rising to 15.2% (878 million) by 2030 and 20.9% (1000 million) by 2045. The prevalence is higher in urban (10.8%) than rural (7.2%) areas, and in high-income (10.4%) than low-income countries (4.0%).Diabetes causes substantial economic burden for individuals, households and health systems, in addition to morbidity and mortality.As per International Diabetes Federation, India has 73 million diabetic patients, the second-largest in the world which is expected to double by 2045 which encompasses a massive economic burden. Non-conventional medicine system was in prevalence is ranged from 9.8% to 76% during COVID-19.27-28 Comorbidities deaths with COVID-19, are more than 57% whereas less than 43% are normal deaths which is more than 85% in Himachal Pradesh.Mortality and morbidity of older adults with diabetic and hypertension due to COVID-19, is increased much more. Objective: To do the Comparative Analysis of Appropriate and Cost Effective System of treatment for Diabetes and Hypertension during COVID-19. Material and Method: A cross-sectional descriptive study is conductedat various institutional levels and by visiting randomly in different selected areas with help of well -developed questionnaire. The research work is conducted by collecting the data of diabetic and hypertension patients with their cost of treatment during COVID-19 in the years 2020, 2021, 2022 and 2023.Sample size is between 947 participantsand total investigations done, are 5498. Results: Total persons investigated are 5498, normal persons are 4551, and diseased persons with diabetes, hypertension and diabetes with hypertension are 947, from these diseased 579 are HTN, 213 are DM and 155 are HTN with DM II. Government price for modern allopathic system for four years for 947 patients of DM-II and HTN, is â‚¹1899125/- and for traditional system is â‚¹268448/-, market price for four years for 947 patients for modern allopathic system is â‚¹17184358/- and for traditional system is â‚¹ 596737/- whereas actual expenditure for modern allopathic system is â‚¹5889198/- and traditional system is â‚¹596737/-. Out of total 947 DM-II and HTN patients, 571 (60.30%) are modern allopathic medicine users, 156 (16.47%) are traditional herbal medicines users and 220(23.23%) are both modern allopathic as well as traditional medicine users. Conclusion:Traditional herbal healthcare system is commonly used for diabetes and hypertension due to the reason that modern allopathic system is more expensive comparatively and the costs of healthcare and prescription drugs rapidly increase each year. High health and medical expenditure has heavy economic burden on government which requires a way to restrain its growth.Out of pocket expenses for health services in Indian, DM-II, HTN and HTN with DM-II patients, in the OPDs, nationwide, prefer go to the private hospitals despite higher out of pocket payments. Total actual expenditure for four years 2020-23, of 947 patients of hypertension, diabetes and hypertension with diabetes, for modern allopathic medicines, is â‚¹5889198/- whereas for traditional herbal medicines is â‚¹596737/-.