Cost-effectiveness of TB treatments to Burmese and Laotian patients by Thai hospitals on the border with Myanmar and Laos

Abstract

Purpose The purpose of this paper is to estimate the cost-effectiveness of tuberculosis (TB) treatment and care in two Thai hospitals located on the borders with Myanmar and Laos. Design/methodology/approach A retrospective data collection was conducted to analyze all costs relevant to TB treatment and care from Mae Sai and Chiang Sean Hospitals. The cost related to TB treatment and care and the number of successful TB treatment from January 1 to December 31, 2017 were used for the calculation. The cost-effectiveness ratio (C/E) and the incremental cost-effectiveness ratio (ICER) were the outcomes. Findings In 2017, the total cost of the TB treatment and care program at Mae Sai Hospital was 482,728.94 baht for 57 TB patients. The cast per treated case per year was 8,468.93 baht. The C/E was 10,971.11 baht per successful TB treatment (44 successful cases). The total cost of the TB treatment and care program at Chiang Sean Hospital was 330,578.73 baht for 39 TB patients. The cost per treated case per year was 8,476.38 baht. The C/E was 22,038.58 baht per successful TB treatment (15 successful cases). The ICER was 5,246.56 baht. The Mae Sai Hospital model was more cost-effective in terms of the treatment and care provided to Burmese patients with TB than the Chiang Sean Hospital model for Laotian patients with TB. Originality/value To improve the cost-effectiveness of TB treatment and care programs for foreign patients in hospitals located on the Thai border, focus should be placed on patient follow-up at the community or village level.

Barriers to accessing TB clinics among Myanmar TB patients attending a Thailand‐Myanmar border hospital: a qualitative approach

“…In 2019, the Chiang Rai Public Health Office reported more than 1,300 confirmed new TB cases in Chiang Rai Province, and 20% of the cases were identified in foreigners [8]. Among the foreigners with TB, 80% were from Myanmar [8].…”

“…In 2019, the Chiang Rai Public Health Office reported more than 1,300 confirmed new TB cases in Chiang Rai Province, and 20% of the cases were identified in foreigners [8]. Among the foreigners with TB, 80% were from Myanmar [8]. People from Myanmar who live along the border, especially in Shan State, face challenges in receiving treatment for TB from their local hospitals, and hence sometimes they cross the border to receive treatment at Mae Sai Hospital in Thailand, which is located less than 3 km from the border [8].…”

“…Among the foreigners with TB, 80% were from Myanmar [8]. People from Myanmar who live along the border, especially in Shan State, face challenges in receiving treatment for TB from their local hospitals, and hence sometimes they cross the border to receive treatment at Mae Sai Hospital in Thailand, which is located less than 3 km from the border [8]. The hospital provides services based on the standard of care for all people, including TB care and treatment [5].…”

“…Approximately 30-50% of the outpatients are from Myanmar [10], and some of them are diagnosed with active TB; 150-200 new TB cases are detected every year [11, 12]. Under the agreement that has been made by hospitals in Thailand and Myanmar, there are three main options for the management of TB patients from Myanmar at Mae Sai hospital [8]: referred back to their local hospital, admission as inpatients to start an intensive treatment regimen or patients from Myanmar who are diagnosed with TB can be asked to stay somewhere in Thailand to undergo follow-up at a TB clinic. TB treatment and care is a generally lengthy process and is expensive.…”