Financial catastrophe from non-communicable diseases: a case study on the economic burden of diabetes on households in Malaysia

Out-of-pocket healthcare payments can impoverish families and drive a vicious cycle of poverty and disease. Using a mixed-methods approach, we investigated the economic burden for households living with chronic diseases in Malaysia. We found that despite having a Universal Health Coverage-based healthcare system, household with diabetes experienced catastrophic healthcare spending and faced impoverishment. Non-poor households were observed to incur higher catastrophic spending, driven by tendencies to seek private care due to inadequacies of public healthcare. Our study may provide insights to design healthcare financing systems with enhanced financial risk and social protection to effectively manage chronic diseases in the long-term.