Cost Analysis of Tuberculosis Disease in the Case of Tuberculosis Control Dispensary

To estimate the direct and indirect costs associated with tuberculosis (TB) prevention, control, and treatment activities conducted at a TB control dispensary in Türkiye and to assess the economic burden of TB at the patient level.

Patient-level cost data for individuals treated in 2023 with International Classification of Diseases, 10^th Revision diagnostic codes A15-A19 were analyzed from the perspective of the healthcare provider. Direct medical costs were calculated based on healthcare service utilization using reimbursement prices specified in the Turkish Social Security Institution's Health Implementation Communiqué. Indirect costs were estimated using patient-reported data and included productivity loss, time spent accessing healthcare services, transportation expenses, and other out-of-pocket expenditures. All costs were calculated as the average annual cost per patient.

The average annual direct cost per patient was $346.39 (9,271.59◊), with prescribed medications constituting the largest component of direct costs. The average annual indirect cost per patient amounted to $1,087.80 (32,013.50◊), mainly driven by productivity losses and time spent in healthcare facilities. Overall, the average annual cost per TB patient was estimated at $1,434.22 (41,285.09◊), with indirect costs accounting for nearly three-quarters of the total economic burden.

The findings demonstrate that TB imposes a substantial economic burden on patients, primarily through indirect costs, even when TB-related healthcare services are covered by the social security system. These results underscore the need for TB control strategies that extend beyond medical care and incorporate social protection and economic support mechanisms to reduce productivity losses and financial vulnerability among patients.