New Delhi: A new research has revealed that a person with TB in India spends, on average, close to Rs 32,000 during treatment. While some of the costs incurred out of the patient’s pocket are direct, such as those spent on diagnosis or hospitalisation, the rest are indirect, for example, costs incurred due to loss of wages.
Despite free diagnosis and care under National TB Elimination Programme (NTEP), research conducted by leading experts from Indian Council for Medical Research (ICMR), TB support network of WHO country office for India, and Central TB Division shows that patients incur high costs, primarily due to lost productivity and hospitalisation.
The researchers measured cost of treatment of over 1,400 TB patients notified under NTEP between May 2022 and Feb 2023. Catastrophic costs were defined as expenditure on TB care being more than 20% of annual household income.
According to results published in Global Health Research and Policy (GHRP) journal, the median of total costs of TB care among the study participants was Rs 32,000 (approx). “Catastrophic costs, experienced by 45% of persons with TB, affected the poor mostly,” the study found.
Enabling early notification of TB, expanding coverage of health insurance schemes to include persons with TB, and implementing TB sensitive strategies to address social determinants of TB may significantly reduce catastrophic costs incurred by patients, the researchers pointed out.
Though TB diagnosis and treatment is free of cost under NTEP, persons with TB incur loss of wages and experience loss of productivity both due to periods of absence from paid work, visits to health facilities for diagnosis, drug collection or follow-up investigations which amounts to non-direct costs.
Direct costs, the researchers pointed out, are incurred mostly before diagnosis or during hospitalisation for TB diagnosis or treatment. “Several health facility visits are made before a person with presumptive TB is diagnosed with TB, with longer pre-diagnosis period leading to higher expenditure,” says the study.
