Impact of DOTS expansion on tuberculosis related outcomes and costs in Haiti

Jacquet, Vary; Morose, Willy; Schwartzman, Kevin; Oxlade, Olivia; Barr, R. Graham; Grimard, Franque; Menzies, Dick

doi:10.1186/1471-2458-6-209

Cited by 26 publications

(40 citation statements)

References 52 publications

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“…The cost of health services (for public TB centre) was slightly lower in pulmonary TB than in extrapulmonary TB because the extrapulmonary TB patients did not carry out laboratory tests and X-ray examination in the TB centres, as patients went to the centre after having done their diagnostic tests The total direct expenditure to the health services for pulmonary TB treatment in the current study is comparable to the cost reported in a study in India which were US$30 to US$43 according to the category of treatment [8]. On the other hand, very high expenditure was found in the study conducted in Haiti where the total direct expenditure for pulmonary TB was US$ 432 per TB patient [18], while in another study conducted in Malaysia, the total direct expenditure to the health services for pulmonary TB was US$ 189.50 [7].…”

Section: Discussionsupporting

confidence: 73%

393 Costs associated with tuberculosis diagnosis and treatment in Yemen for patients and public health services

Othman

Ibrahim²,

Raja'a³

2012

East Mediterr Health J

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This study determined the costs associated with tuberculosis (TB) diagnosis and treatment for the public health services and patients in Sana'a, Yemen. Data were collected prospectively from 320 pulmonary and extrapulmonary TB patients (160 each) who were followed until completion of treatment. Direct medical and nonmedical costs and indirect costs were calculated. The proportionate cost to the patients for pulmonary TB and extrapulmonary TB was 76.1% and 89.4% respectively of the total for treatment. The mean cost to patients for pulmonary and extrapulmonary TB treatment was US$ 108.4 and US$ 328.0 respectively. The mean cost per patient to the health services for pulmonary and extrapulmonary TB treatment was US$ 34.0 and US$ 38.8 respectively. For pulmonary and extrapulmonary TB, drug treatment represented 59.3% and 77.9% respectively of the total cost to the health services. The greatest proportionate cost to patients for pulmonary TB treatment was time away from work (67.5% of the total cost), and for extrapulmonary TB was laboratory and X-ray costs (55.5%) followed by transportation (28.6%). Coûts associés au diagnostic et au traitement de la tuberculose pour les patients et les services de santé publics au Yémen RÉSUMÉ La présente étude a déterminé les coûts associés au diagnostic et au traitement de la tuberculose pour les services de santé publics et pour les patients à Sanaa (Yémen). Les données ont été recueillies de façon prospective auprès de 320 patients atteints de tuberculose pulmonaire et extrapulmonaire (160 pour chaque forme), suivis jusqu'à la fin de leur traitement. Les coûts médicaux et non médicaux directs et les coûts indirects ont été calculés. La part du coût supportée par les patients était de 76,1 % du coût total du traitement dans le cas de la tuberculose pulmonaire, et de 89,4 % dans le cas de la tuberculose extrapulmonaire. Le coût moyen du traitement de la tuberculose pulmonaire et extrapulmonaire pour les patients était respectivement de 108,4 USD et 328,0 USD, ce qui équivalait à un coût moyen par patient de 34,0 USD et 38,8 USD, respectivement. Pour les services de santé, le traitement médicamenteux de la tuberculose pulmonaire et extrapulmonaire représentait 59,3 % et 77,9 % respectivement du coût total. Pour les patients atteints de tuberculose pulmonaire, l'absence du travail représentait le coût le plus important du traitement (67,5 % du coût total) ; pour les patients atteints de tuberculose extrapulmonaire, les dépenses liées aux analyses de laboratoire et auxradiographies (55,5 %) étaient les coûts proportionnellement les plus importants, suivies par les frais de transport (28,6 %).

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Section: Discussionsupporting

confidence: 73%

393 Costs associated with tuberculosis diagnosis and treatment in Yemen for patients and public health services

Othman

Ibrahim²,

Raja'a³

2012

East Mediterr Health J

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“…To Steffen et al (2010), the ICER was USD 6,616 per completed DOT treatment [13]. Studies conducted in Ecuador and Haiti suggest that implementation of DOT would result in benefits for the government and society after a 20-year period [21,22]. Other studies did not find any benefits justifying implementation of DOT to combat tuberculosis.…”

Section: Discussionmentioning

confidence: 99%

“…This outcome was measured as the number of lives saved, corresponding to patients cured as a result of the adopted strategy [21][22][23].…”

Section: Effectivenessmentioning

confidence: 99%

Cost-Effectiveness Analysis of Directly Observed Therapy for Tuberculosis and Its Expansion in Rio De Janeiro

Moura

Mosegui

Vianna

et al. 2017

Int J Pharm Pharm Sci

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Objective: Brazil is one of the countries with the largest number of cases of tuberculosis worldwide. Rio de Janeiro exhibits some of highest mortality and incidence rates in the country. The aim of the present study was to perform a cost-effectiveness analysis of directly observed therapy (DOT) and simulate its expansion for new cases of pulmonary tuberculosis in Rio de Janeiro. Methods:A decision tree was plotted that simulated the progression of the disease for six months. In the cost-effectiveness analysis, strategies of self-administered treatment (SAT) and DOT (directly observed therapy) with 100% coverage were compared; the current coverage, 48%, and coverage of 100% were considered with regard to expansion. The study was based on the epidemiological pattern of tuberculosis in Rio de Janeiro among adults from both genders and without economic differences; the government perspective was adopted. The outcomes were varied to investigate the occurrence of parametric sensitivity. Results:Although the cost of treatment was increased by three times, DOT proved to be cost-effective for the treatment of new cases, with an incremental cost-effectiveness ratio (ICER) of BRL 30,454 per saved life. Expansion of DOT coverage would avert 180 deaths and 171 instances of treatment dropout, in addition to providing an incremental 420 instances of cure, with an investment of approximately BRL 6,700,000.00. Conclusion:DOT might contribute to improving the current tuberculosis situation in the state of Rio de Janeiro. Its expansion would fit with the resources estimated by the Brazilian government needed to combat non-drug-resistant tuberculosis.

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“…[15,16] In the Indian study, the cost of health services was US$46.00, whereas in the Pakistan study, the cost amounted to US$50.26. On the other hand, very high expenditures were determined in the Haitian study, [17] which evaluated the total direct medical cost per PTB patient to be US$432.00. The Malaysian, [3] Ethiopian, [12] Brazilian, [18] and Tanzanian [19] studies reported that the total direct medical cost of treating a PTB patient was US$95.60, US$189.50, US$103.00, and US$115.30, respectively.…”

Section: Discussionmentioning

confidence: 99%