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Anti-tuberculosis programs in Thailand: a cost analysis
B Chunhaswasdikul1, P Kamolratanakul, A Jittinandana
1Department of Communicable Disease Control, Ministry of Public Health (MOPH), Bangkok, Thailand.
Summary
Short-course chemotherapy for tuberculosis (TB) is more cost-effective for providers than the standard regimen in Thailand. A regimen of isoniazid, rifampicin, and pyrazinamide showed the lowest overall cost.
Area of Science:
- Public Health
- Pharmacoeconomics
- Infectious Disease Management
Background:
- The standard tuberculosis (TB) treatment in Thailand, using isoniazid and thiacetazone, is inexpensive but toxic, leading to poor compliance and low success rates.
- Short-course chemotherapy (SCC) offers higher efficacy but is limited by drug costs, with total care costs often overlooked.
Purpose of the Study:
- To compare the total provider costs of three short-course chemotherapy regimens against the standard regimen for treating newly diagnosed pulmonary TB in Thailand.
Main Methods:
- A comparative cost analysis was conducted at four TB centers in Thailand between 1987-1988.
- Provider costs, including drug and routine service costs, were analyzed for four different TB treatment regimens.
Main Results:
- All three short-course chemotherapy regimens demonstrated lower total provider costs compared to the standard regimen.
- The regimen of isoniazid, rifampicin, and pyrazinamide for two months, followed by isoniazid and rifampicin twice weekly for four months, incurred the lowest total cost (Baht 1,499).
- Despite its low drug cost (Baht 431), the standard regimen had the highest total provider costs (Baht 2,541) due to substantial routine service expenses (Baht 2,066).
Conclusions:
- Short-course chemotherapy regimens are more cost-effective from a provider's perspective for treating pulmonary tuberculosis in Thailand.
- Comprehensive cost analysis, including drug and service costs, is crucial for evaluating the true economic impact of TB treatment strategies.