Cost of three models of care for drug-resistant tuberculosis patients in Nigeria
JournalBMC Infectious Diseases
PublisherBioMed Central Ltd.
MetadataShow full item record
AbstractBackground: Nigeria accounts for a significant proportion of the global drug-resistant tuberculosis (DR-TB) burden, a large proportion of which goes untreated. Different models for managing DR-TB treatment with varying levels of hospitalization are in use across Nigeria, however costing evidence is required to guide the scale up of DR-TB care. We aimed to estimate and compare the costs of different DR-TB treatment and care models in Nigeria. Methods: We estimated the costs associated with three models of DR-TB treatment and care: Model (A) patients are hospitalized throughout the 8-month intensive phase, Model (B) patients are partially hospitalized during the intensive phase and Model (C) is entirely ambulatory. Costs of treatment, in-patient and outpatient care and diagnostic and monitoring tests were collected using a standardized data collection sheet from six sites through an ingredient's approach and cost models were based on the Nigerian National Tuberculosis, Leprosy and Buruli Ulcer Guideline - Sixth Edition (2014) and Guideline for programmatic and clinical management of drug-resistant tuberculosis in Nigeria (2015). Results: Assuming adherence to the Nigerian DR-TB guidelines, the per patient cost of Model A was 18,528 USD, Model B 15,159 USD and Model C 9425 USD. Major drivers of cost included hospitalization (Models A and B) and costs of out-patient consultations and supervision (Model C). Conclusion: Utilizing a decentralized ambulatory model, is a more economically viable approach for the expansion of DR-TB care in Nigeria, given that patient beds for DR-TB treatment and care are limited and costs of hospitalized treatment are considerably more expensive than ambulatory models. Scale-up of less expensive ambulatory care models should be carefully considered in particular, when treatment efficacy is demonstrated to be similar across the different models to allow for patients not requiring hospitalization to be cared for in the least expensive way. Copyright 2019 The Author(s).
SponsorsThis work was supported by the Global Fund New Funding Model MDR-TB grant to Nigeria with IHVN serving as the principal recipient. The funder had no role in the design, data collection, analysis and interpretation of results in this study.
Identifier to cite or link to this itemhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85059829417&doi=10.1186%2fs12879-018-3636-1&partnerID=40&md5=6deeac9b8f666584d4b94b8845f692e5; http://hdl.handle.net/10713/8645
- Cost comparison of nine-month treatment regimens with 20-month standardized care for the treatment of rifampicin-resistant/multi-drug resistant tuberculosis in Nigeria.
- Authors: Bada FO, Blok N, Okpokoro E, Dutt S, Akolo C, Dakum P, Abimiku A
- Issue date: 2020
- Cost-optimization in the treatment of multidrug resistant tuberculosis in Nigeria.
- Authors: Musa BM, John D, Habib AG, Kuznik A
- Issue date: 2016 Feb
- What is the cost of diagnosis and management of drug resistant tuberculosis in South Africa?
- Authors: Pooran A, Pieterson E, Davids M, Theron G, Dheda K
- Issue date: 2013
- Cost of multi drug resistance tuberculosis in Germany.
- Authors: Diel R, Nienhaus A, Lampenius N, Rüsch-Gerdes S, Richter E
- Issue date: 2014 Nov
- Costs of inpatient treatment for multi-drug-resistant tuberculosis in South Africa.
- Authors: Schnippel K, Rosen S, Shearer K, Martinson N, Long L, Sanne I, Variava E
- Issue date: 2013 Jan