Patient costs during tuberculosis treatment in Bangladesh and Tanzania: the potential of shorter regimens

• Published in: The international journal of tuberculosis and lung disease Vol. 18; no. 7; pp. 810 - 817
• Main Authors: Gospodarevskaya, E., Tulloch, O., Bunga, C., Ferdous, S., Jonas, A., Islam, S., Rahman, M., Hussain, M. A., Haque, M. N., Egwaga, S., Gardiner, E., PrayGod, G., Islam, M. A., Mann, G. H., Wells, W. A., Squire, S. B.
• Format: Journal Article
• Language: English
• Published: Paris International Union Against Tuberculosis and Lung Disease 01.07.2014; International Union against Tuberculosis and Lung Disease
• Subjects: Access; Adult; Antitubercular Agents - administration & dosage; Antitubercular Agents - economics; Antitubercular Agents - therapeutic use; Bacterial diseases; Bangladesh; Biological and medical sciences; Cross-Sectional Studies; Drug Administration Schedule; Drug Costs; Efficiency; Female; Financing, Personal - economics; Human bacterial diseases; Humans; Infectious diseases; Male; Medical sciences; Mycobacterium; Patient Preferences; Pneumology; Poverty; Surveys and Questionnaires; Tanzania; Time Factors; Travel - economics; Treatment Costs; Tuberculosis - drug therapy; Tuberculosis - economics; Tuberculosis and atypical mycobacterial infections; Bangladesh; Asia; Africa; Tanzania; Human; Costs; Poverty; access; Accessibility; Respiratory disease; Patient; Mycobacterial infection; Potential; Infection; Treatment; Tuberculosis; treatment costs; Preference; Health economy; patient preferences; Bacteriosis; Economic aspect; Social aspect; Public health
• ISSN: 1027-3719; 1815-7920
• DOI: 10.5588/ijtld.13.0391

OBJECTIVE To estimate the costs incurred by patients during the intensive and continuation phases of the current 6-month tuberculosis (TB) regimen in Bangladesh and Tanzania, and thus identify potential benefits to patients of a shorter, 4-month treatment regimen. DESIGN The validated Stop TB patient cost questionnaire was adapted and used in interviews with 190 patients in the continuation phase of treatment with current regimens. RESULTS In both countries, overall patient costs were lower during 2 months of the continuation phase (US$74 in Tanzania and US$56 in Bangladesh) than during the 2 months of the intensive phase of treatment (US$150 and US$111, respectively). However, continuation phase patient costs still represented 89% and 77% of the 2-month average national income in the respective countries. Direct travel costs in some settings were kept low by local delivery system features such as community treatment observation. Lost productivity and costs for supplementary foods remained significant. CONCLUSIONS Although it is not a straightforward exercise to determine the exact magnitude of likely savings, a shorter regimen would reduce out-of-pocket expenses incurred by patients in the most recent 2 months of the continuation phase and allow an earlier return to productive activities.