Estimating the economic burden of stroke in Iran: evidence from a cost-of-illness study

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. 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. 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. 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.