How much do Indians pay for tuberculosis treatment? A cost analysis

Area of Science:

• Public Health
• Health Economics
• Tuberculosis Research

Background:

• India's National Tuberculosis Elimination Programme (NTEP) aims to cover TB treatment costs.
• Despite program coverage, individuals with TB (PLWTB) experience substantial financial distress from direct and indirect expenses.

Purpose of the Study:

• To analyze the financial impact of TB on individuals in India.
• To understand the magnitude and patterns of TB-related costs from the patient's perspective.

Main Methods:

• Systematic literature review using keywords like 'tuberculosis,' 'India,' 'cost,' and 'out of pocket.'
• Calculation of variance-weighted mean costs for direct and indirect expenditures.

Main Results:

• PLWTB incur significant direct costs (mean US$46.8) and substantial indirect costs (mean US$666.6), which form 93.4% of total costs.
• Pre-diagnosis costs can be four times higher than treatment costs; private sector treatment is six times costlier than public sector care.
• One in three PLWTB in India face catastrophic financial costs due to TB.

Conclusions:

• High direct and indirect costs associated with TB disproportionately affect individuals in India.
• Interventions are crucial to reduce diagnostic delays, minimize travel expenses, enhance awareness of NTEP services, and improve inpatient care reimbursement to eliminate catastrophic costs.