The Economic Cost of Type 2 Diabetes in Indonesia: A Systematic Review.

Background: Type 2 diabetes (T2D) imposes a growing economic burden in Indonesia, driven by rising prevalence and associated complications. This review synthesizes current evidence on the economic costs of T2D in Indonesia to inform policy decisions aimed at alleviating these financial impacts. Methods: A systematic review was conducted using the PRISMA guidelines and the PICOS framework, analyzing studies from major databases including PubMed, ProQuest, EBSCO, ScienceDirect, and Google Scholar published from 2019-2025. Studies included addressed both direct costs and/or indirect costs related to T2D in Indonesia, and reported annual or monthly per-patient costs. Results: Six studies were included in the analysis, representing a diverse geographical coverage and various healthcare facilities, with the majority being tertiary facilities. The average annual direct cost per patient with complications reached USD 1,607.7, compared to USD 427.3 for patients without complications, a difference of 3.8 times. Limited indirect cost data show USD 35.2 for patients with complications versus USD 20.5 for cases without complications. Hospitalization, medications, and medical procedures are the main cost drivers. Only three studies reported indirect costs, indicating a potential underestimation of the total economic burden. Conclusion: T2D complications increase healthcare costs by nearly four times. These findings support a shift in policy towards prevention, expansion of screening through insurance, and strengthening of primary services. Standardized methodologies and the inclusion of indirect costs are needed for more accurate study comparisons and policy guidance.