Multidrug‐Resistant Tuberculosis

Abstract

The costs of multidrug-resistant tuberculosis (MDR TB) reach far beyond the cost of the clinical treatment of the patient. The first impact of the discovery of MDR TB in a population is the need to recognize that all TB patients have the potential of being MDR. Public health measures to prevent the spread of MDR TB, or to control or reverse the problem where spread has already occurred, can be extremely expensive to implement. At the level of the individual patient, the second-line drugs used to treat MDR TB are more expensive, and the remaining first-line drugs will have to be used for a longer time than in drug-susceptible TB. Negative-pressure units add to the costs of treatment, as does the increased nursing intensity required. The cost to the wider economy includes lost productivity and lost tax revenue to the state as well as the cost of supporting the family if the patient is the breadwinner.

Drug-resistant tuberculosis: A disease of target populations in Houston, Texas

“…First, treatment cost is significantly higher. [2][3][4] Second, if DRTB exists in a certain population, most patients with TB are treated initially as if they had DRTB. 4,5 Third, MDRTB patients have lower cure rates and higher mortality rates than those with DSTB.…”

“…[2][3][4] Second, if DRTB exists in a certain population, most patients with TB are treated initially as if they had DRTB. 4,5 Third, MDRTB patients have lower cure rates and higher mortality rates than those with DSTB. 2,[6][7][8] The distribution of DRTB and MDRTB is worldwide.…”

Drug-Resistant Tuberculosis in Sub-Saharan Africa

“…Indeed, when factoring in length of hospitalization, additional monitoring and testing, and increased health-care worker demands (eg, nursing, pharmacy, specialist input), the cost of treating a case of MDR-TB is exponentially higher than the cost of treating a case of drug-susceptible TB [29,30].…”

Expanding metabolism for total biosynthesis of the nonnatural amino acid L-homoalanine

“…The R-enantiomer of levetiracetam has no antiepileptic activity (1) and (R, R)-form of ethambutol can cause blindness (2). Even though ethambutol and levetiracetam are now generic drugs, in many countries the cost of just one month's supply exceeds the entire annual per capita health expenditure (3). The prohibitive drug price has created global healthcare problems.…”