The value of effective public tuberculosis treatment: an analysis of opportunity costs associated with multidrug resistant tuberculosis in Latvia

Cost Effectiveness and Resource Allocation

Vaira Leimane⁴  Patrick K Moonan¹  Kevin P Cain¹  Vija Riekstina³  Timothy H Holtz²  Fernando A Wilson⁵  Andra Cirule³  Thaddeus L Miller⁵ 

[1] Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, GA, USA;Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA;State Agency Infectology Center of Latvia, Riga, Latvia;World Health Organization Collaborative Center for Research and Training in Management of Multidrug-resistant Tuberculosis, State Agency Infectology Center of Latvia, Riga, Latvia;University of North Texas Health Science Center at Fort Worth, School of Public Health, Fort Worth, TX, USA

关键词: Evidence based policy;    Cost analysis;    Health economics;    Tuberculosis cost;   

Others  :  810707
DOI  :  10.1186/1478-7547-11-9

 received in 2012-12-05, accepted in 2013-04-11,  发布年份 2013

【 摘 要 】

Background

A challenge to effective protection against tuberculosis is to sustain expensive and complex treatment public programs. Potential consequences of program failure include acquired drug resistance, poor patient outcomes, and potentially much higher system costs, however. In contrast, effective efforts have value illustrated by impacts they prevent. We compared the healthcare costs and treatment outcomes among multidrug-resistant tuberculosis (MDR-TB) and non MDR-TB patients in Latvia to identify benefits or costs associated with both.

Methods

We measured and compared costs, healthcare utilization, and outcomes for patients who began treatment through Latvia’s TB control program in 2002 using multivariate regression analysis and negative binomial regression.

Results

We analyzed data for 92 MDR-TB and 54 non MDR-TB patients. Most (67%) MDR-TB patients had history of prior tuberculosis treatment. MDR-TB was associated with lower cure rates (71% vs. 91%) and greater resource utilization. MDR-TB treatment cost almost $20,000 more than non MDR-TB.

Conclusion

Up to 2/3 of MDR-TB treated in our sample was preventable at a potential savings of over $1.3 million in healthcare resources as well as substantial individual health.

【 授权许可】

   
2013 Miller et al.; licensee BioMed Central Ltd.

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