A systematic synthesis of direct costs to treat and manage tuberculosis disease applied to California, 2015

Abstract

BackgroundThe cost of treating and managing cases of active tuberculosis (TB) disease—from diagnosis to treatment completion—is needed by agencies working on public health budgets, resource allocation and cost-effectiveness analysis. Although components of TB costs have been published in the United States (US), no recent study has assessed overall costs for TB care and potential gaps. To systematically review the US literature for costs of treating and managing cases of active TB disease, adjust these costs to current (2015) values, and assess gaps. We quantified total direct costs—from the perspective of the health care payer—of the treatment and case management of active TB disease. Estimates were based on published figures in the US, and operational data of the California Department of Public Health.ResultThe average direct cost of treating and managing a TB case was $34,600 in 2015. The average cost of a multidrug-resistant TB case was $110,900. Health care spending for treating and case managing TB patients in California amounted to approximately $75.6 million for the 2133 new cases reported in 2015. Most published cost estimates were based on data from the 1990s.ConclusionTB is resource-intensive to treat and manage. Our synthesis provides inputs for budgets and economic analyses. New studies to provide original cost data are needed to better reflect current clinical and public health practices.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-017-2754-y) contains supplementary material, which is available to authorized users.

Cost-effectiveness of video-observed therapy for ambulatory management of active tuberculosis during the COVID-19 pandemic in a high-income country

“…The costs per session of DOT and VOT were adopted from the findings of a cost-minimization analysis of various types of observed therapy for TB management in the US (Lam et al, 2019). The cost per case of TB outpatient clinic care was retrieved from the results of a direct cost analysis of TB in the US (Oh et al, 2015). The drug treatment cost was estimated using the drug cost listed in online pharmacy (Drugs.com, 2021).…”

Challenges Across the HIV Care Continuum for Patients With HIV/TB Co-infection in Atlanta, GA

“…Studies of interventions to improve retention in care and VS in these patients have had limited efficacy, and a recent study using patient navigators and contingency management failed to improve viral suppression 6 months after the intervention ended [35]. While the durability of financial incentives for HIV care is unclear, the cost of treatment of 1 TB case has been estimated to be US $34 600, and risk of TB recurrence could justify their use [36, 37]. Innovative strategies tailored to local populations are needed to improve the HIV care continuum.…”

A narrative review of tuberculosis in the United States among persons aged 65 years and older

“…In northern California, active TB disease has been associated with 7% mortality within one year of diagnosis and 16.3% mortality beyond one year, with an average of seven years of potential life lost [1] . In 2018, approximately 5,000 TB-related hospitalizations occurred in the U.S. [2] with an average length of stay of nine days and costs ranging from $10,100-$45,400 [3] , [4] .…”