{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T20:10:25Z","timestamp":1779394225321,"version":"3.53.1"},"reference-count":40,"publisher":"The Journal of Health Economics and Outcomes Research","issue":"2","license":[{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["jheor.org"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cystic fibrosis (CF) is a rare genetic disorder that places a substantial financial burden on patients, families, and the healthcare system. This study aimed to estimate the economic impact of CF in southern Iran.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional, prevalence-based cost-of-illness study was conducted from a societal perspective, using a bottom-up approach and the human capital method. Data were collected through insurance records and a standardized cost questionnaire. Mean annual per-patient costs were calculated, and cost determinants were analyzed using the Mann-Whitney and Kruskal-Wallis tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The average annual cost per CF patient was US $4070, with 67% attributed to direct medical costs, 20% to direct nonmedical costs, and 13% to indirect costs. Higher total costs were significantly associated with disease severity, hospitalization history, and absence of supplementary insurance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"conclusion\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CF imposes a considerable economic burden in Iran, predominantly driven by drug and hospitalization expenses. Direct nonmedical costs and indirect costs also contribute meaningfully. These findings highlight the need for improved access to specialized CF care, enhanced insurance coverage, and stronger support for informal caregivers to alleviate the financial pressure on affected families.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.36469\/001c.143266","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T15:40:46Z","timestamp":1757432446000},"update-policy":"https:\/\/doi.org\/10.36469\/00001","source":"Crossref","is-referenced-by-count":1,"title":["Societal Economic Burden of Cystic Fibrosis in Iran: A Cost-of-Illness Study"],"prefix":"10.36469","volume":"12","author":[{"given":"Hassan","family":"Karami","sequence":"first","affiliation":[{"name":"Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shideh","family":"Rafati","sequence":"additional","affiliation":[{"name":"Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Shirvani Shiri","sequence":"additional","affiliation":[{"name":"Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran"},{"name":"Department of Health Services Management, School of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Mouseli","sequence":"additional","affiliation":[{"name":"Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hedayat","family":"Salari","sequence":"additional","affiliation":[{"name":"Department of Health Policy & Management, School of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amin","family":"Ghanbarnejad","sequence":"additional","affiliation":[{"name":"Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitra","family":"Nowrouzpour","sequence":"additional","affiliation":[{"name":"National Center for Health Insurance Research, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatemeh","family":"Noroozian","sequence":"additional","affiliation":[{"name":"Department of Health Services Management, School of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Alizadeh","sequence":"additional","affiliation":[{"name":"Department of Health Services Management, School of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatemeh","family":"Asadi","sequence":"additional","affiliation":[{"name":"Student Research Committee, Faculty of Nursing and Midwifery, Hormozgan University of Medical Sciences, Bandar Abbas, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narges","family":"Salehi","sequence":"additional","affiliation":[{"name":"Student Research Committee, Faculty of Nursing and Midwifery, Hormozgan University of Medical Sciences, Bandar Abbas, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"22273","published-online":{"date-parts":[[2025,9,9]]},"reference":[{"issue":"1","key":"ref1","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/S2213-2600(19)30337-6","article-title":"The future of cystic fibrosis care: a global perspective","volume":"8","author":"S.C. 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