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  1. Home
  2. Health-service Costs For The Treatment Of Multidrug-resistant/rifampicin-resistant Tuberculosis In South African Children: Application Of A Real-world Dataset.
  1. Home
  2. Health-service Costs For The Treatment Of Multidrug-resistant/rifampicin-resistant Tuberculosis In South African Children: Application Of A Real-world Dataset.

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Health-Service Costs for the Treatment of Multidrug-Resistant/Rifampicin-Resistant Tuberculosis in South African

Thomas Wilkinson1, Arne von Delft2, Anneke C Hesseling3

  • 1Health Economics Unit, School of Public Health, University of Cape Town, Cape Town, South Africa. tommy.d.wilkinson@gmail.com.

Pharmacoeconomics
|November 12, 2025

View abstract on PubMed

Summary
This summary is machine-generated.

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Multidrug-resistant tuberculosis (MDR-TB) treatment in children is expensive. Real-world data analysis reveals younger age, HIV, and extrapulmonary TB drive higher costs, with a few patients incurring substantial expenses.

Area of Science:

  • Health economics
  • Public health
  • Infectious disease epidemiology

Background:

  • Children with multidrug-resistant (MDR)/rifampicin-resistant (RR) tuberculosis (TB) are a neglected group in cost-effectiveness research.
  • Digital health information systems offer new avenues for health-service cost analysis.
  • The Provincial Health Data Centre (PHDC) in South Africa collects comprehensive health system data.

Purpose of the Study:

  • To conduct a health-service cost analysis for children treated for MDR/RR-TB.
  • To identify key cost drivers and understand cost variation in pediatric MDR/RR-TB treatment.
  • To utilize routinely collected data for accurate cost insights.

Main Methods:

  • Anonymized, integrated PHDC data from 2018-2021 for children treated for MDR/RR-TB.
  • Costing health-service utilization using local unit prices.
  • Log-linear regression to identify cost drivers and gamma distribution fitting for cost data.
  • Main Results:

    • Significant cost variation observed (median US$7576) among 271 children.
    • Younger age, extrapulmonary TB, HIV co-infection, and longer treatment duration significantly impacted costs.
    • Total per-patient costs followed a gamma distribution, indicating skewed cost distribution.

    Conclusions:

    • Pediatric MDR/RR-TB treatment imposes substantial costs on health systems.
    • Routinely collected data from health information systems provide accurate cost insights.
    • Highly skewed costs necessitate targeted interventions, informing program development and policy.