Jai B Mullerpattan1, Zal Z Udwadia2, Radhika A Banka3, Shashank R Ganatra4, Zarir F Udwadia5. 1. Associate Consultant, Department of Respiratory Medicine, P.D. Hinduja National Hospital and MRC, Mumbai, India. Electronic address: jaimuller@hotmail.com. 2. Project Management, Abbott India Ltd, Mumbai, India. 3. Speciality Registrar, Department of Respiratory Medicine, Norfolk and Norwich University Hospital, Norwich, United Kingdom. 4. Research Fellow, Department of Respiratory Medicine, P.D. Hinduja National Hospital and MRC, Mumbai, India. 5. Consultant, Department of Respiratory Medicine, P.D. Hinduja National Hospital and MRC, Mumbai, India.
Abstract
BACKGROUND: Private healthcare is choice of point of care for 70% of Indians. Multidrug resistant tuberculosis (MDR-TB) treatment is costly and involves duration as long as 2 years. AIM: To estimate costs to patients undergoing treatment for MDR-TB. METHODS: A health-economics questionnaire was administered to 50 consecutive patients who successfully completed ambulatory private treatment for MDR-TB. Direct costs included drug costs, investigations, consultation fees, travel costs, hospitalisation and invasive procedures and cost prior to presentation to us. Indirect costs included loss of income. RESULTS: Of our cohort of 50 patients, 36 had pulmonary TB while 14 had extra-pulmonary TB (EPTB). 40 had MDR-TB and 10 had XDR-TB. There were 15 males and 35 females. Mean age was 30 years (range 16-61 years). Treatment cost for pulmonary MDR-TB averaged $5723 while it averaged $8401 for pulmonary XDR-TB and $5609 for EPTB. The major expense was due to drug costs (37%) while consultation fees were only 5%. Annual individual income for the cohort ranged from $0 to $63,000 (mean $11,430). On average, the cost of treatment ranged from 2.56% to 180.34% of the annual family income. 34/50 (68%) had total costs greater than 20% of annual family income and 39/50 (78%) had total costs greater than 10% of annual family income. The number of patients with total costs >40% of total family income was 22. CONCLUSION: MDR-TB in the private sector results in "catastrophic health costs". Financial and social support is essential for patients undergoing treatment for MDR-TB.
BACKGROUND: Private healthcare is choice of point of care for 70% of Indians. Multidrug resistant tuberculosis (MDR-TB) treatment is costly and involves duration as long as 2 years. AIM: To estimate costs to patients undergoing treatment for MDR-TB. METHODS: A health-economics questionnaire was administered to 50 consecutive patients who successfully completed ambulatory private treatment for MDR-TB. Direct costs included drug costs, investigations, consultation fees, travel costs, hospitalisation and invasive procedures and cost prior to presentation to us. Indirect costs included loss of income. RESULTS: Of our cohort of 50 patients, 36 had pulmonary TB while 14 had extra-pulmonary TB (EPTB). 40 had MDR-TB and 10 had XDR-TB. There were 15 males and 35 females. Mean age was 30 years (range 16-61 years). Treatment cost for pulmonary MDR-TB averaged $5723 while it averaged $8401 for pulmonary XDR-TB and $5609 for EPTB. The major expense was due to drug costs (37%) while consultation fees were only 5%. Annual individual income for the cohort ranged from $0 to $63,000 (mean $11,430). On average, the cost of treatment ranged from 2.56% to 180.34% of the annual family income. 34/50 (68%) had total costs greater than 20% of annual family income and 39/50 (78%) had total costs greater than 10% of annual family income. The number of patients with total costs >40% of total family income was 22. CONCLUSION: MDR-TB in the private sector results in "catastrophic health costs". Financial and social support is essential for patients undergoing treatment for MDR-TB.
Authors: P Sinha; M Carwile; A Bhargava; C Cintron; C Acuna-Villaorduna; S Lakshminarayan; A F Liu; N Kulatilaka; L Locks; N S Hochberg Journal: Public Health Action Date: 2020-09-21
Authors: Mihir P Rupani; Adithya Cattamanchi; Priya B Shete; William M Vollmer; Sanjib Basu; Jigna D Dave Journal: Infect Dis Poverty Date: 2020-10-19 Impact factor: 4.520