Cost analysis of different types of tuberculosis patient at tuberculosis centers in Thailand
Kamolratanakul, P.; Hiransuthikul, N.; Singhadong, N.; Kasetjaroen, Y.; Akksilp, S.; Lertmaharit, S.
Southeast Asian Journal of Tropical Medicine and Public Health 33(2): 321-330
2002
ISSN/ISBN: 0125-1562 PMID: 12236432 Document Number: 541135
Tuberculosis (TB) has recently re-emerged as a major public health problem in Thailand. As a consequence of the HIV epidemic in the country, the TB burden has been rising in terms of both morbidity, and mortality which have tremendous socioeconomic impact. However, a study of the cost of various anti-TB drugs in Thailand has never been conducted. A specific aim of this study was to compare the total provider costs of delivering services to different types of TB patient in four zonal TB centres located in the east, northeast, north, and south of Thailand. This aim was accomplished by calculating the unit costs of TB treatment services at these TB centres during the year 1996-97. All units of the zonal TB centres were classified into five cost-centre categories: treatment units, laboratory units, radiology units, pharmaceutical units, and administrative/supportive units. The results showed that the average total provider cost of multi-drug resistant TB (MDR TB) patients was baht 89 735.49 which was the highest of any type of patient and was 17 times higher than the cost of smear-negative TB cases; this finding was attributed to the high cost of anti-TB drugs for MDR TB cases (baht 65 870), some 95 times higher than the cost for smear-negative cases. Total provider costs were highest in the northeastern region TB centres and lowest in the southern centres for every type of TB patient: smear-negative TB cases (baht 7727 vs. baht 3916), newly smear positive TB cases (baht 12 539 vs. baht 7020), TB with AIDS cases (baht 15 108 vs. baht 8369), re-treatment TB cases (baht 16 679 vs. baht 9696), and MDR TB cases (baht 102 330 vs. baht 82 933). The information from this study may be useful when reviewing the role, function, and cost structure of each TB centre in Thailand in order to establish a strategic plan for effective TB control.