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Cost analysis of paediatric tuberculosis treatment in Japan
M Rahman1, O Takahashi, I Takamatsu
1Department of General Medicine and Clinical Epidemiology, Kyoto University, Kyoto, Japan. rahman@kuhp.kyoto-u.ac.jp
Insights
Treating a pediatric tuberculosis (TB) case in Japan costs significantly less than preventing one through vaccination. This finding suggests a need to re-evaluate the national BCG vaccination policy.
Area of Science:
- Public Health
- Health Economics
- Pediatric Infectious Diseases
Background:
- Tuberculosis (TB) remains a significant global health concern, necessitating accurate cost-of-illness assessments.
- Understanding the economic burden of pediatric TB is crucial for resource allocation and policy development.
Purpose of the Study:
- To estimate the treatment cost of pediatric tuberculosis (TB) in Japan.
- To analyze TB-related medical service utilization patterns.
- To compare the cost of treating TB with the cost of preventing TB.
Main Methods:
- A retrospective cost-of-illness study was conducted on 57 pediatric TB patients at a public hospital in Osaka, Japan (1993-1998).
- Medical records were analyzed to abstract in- and out-patient service utilization.
- Costs were estimated from a third-party payer perspective; prevention costs were sourced from literature.
Main Results:
- The average cost to treat a pediatric TB case was $8,384 USD, with an average hospitalization of 63 days.
- The cost of preventing a TB case through vaccination ranged from $35,950 to $175,862 USD.
- Univariate analysis showed TB site and case-finding method influenced cost and hospitalization length, but multivariate analysis found no significant predictors.
Conclusions:
- The cost of treating pediatric TB is substantially lower than the cost of preventing it.
- Japan's universal BCG vaccination policy warrants re-examination considering economic, social, and political factors.
Objective:
To estimate the cost of treating a tuberculosis (TB) case and to analyse TB-related medical service utilisation, a cost-of-illness study was conducted for all patients with a primary diagnosis of TB admitted to a public hospital in Japan.
Methods:
Retrospective analysis by abstracting in- and out-patient medical records of 57 paediatric patients diagnosed with TB during 1993-1998 at a public hospital in Osaka prefecture. Costs were estimated based on third party's payer perspectives according to the service utilisation pattern. In addition to cost data, sociodemographic information and service utilisation pattern were also extracted from the medical records. Cost of preventing a case of TB was abstracted from the published literature.
Results:
The average cost of treatment was 8384 US dollars (95%CI 5667-11,099), while the average length of hospitalisation was 63 days (95%CI 43-84). Based on 20-80% vaccine efficacy, the cost of preventing a case of TB was 35,950-175,862 US dollars. In univariate analysis, site of TB (P = 0.04) was significantly associated with TB treatment cost, while case-finding method (contact tracing, symptoms, etc.) was associated with length of hospitalisation (P = 0.03). Multivariate regression analysis, however, showed none of the factors to be significant predictors of TB treatment cost and length of hospital stay.
Conclusion:
The cost of treating a case of paediatric TB is much lower than that of preventing one. Japan's universal BCG vaccination policy should be re-examined in the light of economic, social and political issues.