India TB Costs of Treatment

Part
01
of two
Part
01

Drug Sensitive TB Treatment Cost in India

A list of 8 sources on the treatment cost for drug-susceptible tuberculosis (DS-TB) in India has been compiled in this spreadsheet. A link to the source, source published date, the location of information, and other relevant details have been provided.

Average overall DOTS cost could vary depending on whether the TB was pulmonary or extra pulmonary. Pulmonary tuberculosis had an average cost of $85.40, extra pulmonary had a cost of $164.90, and having both pulmonary and extra pulmonary TB cost $228.30.

A cost breakdown includes a standard course of drugs at Rs. 1000. Another source indicates direct medical costs are at $61/month for DS-TB care (base care), $48/month for improved DS-TB care, and $42/visit in fixed costs.

If treatment is obtained by the government's RNTCP program, "both diagnosis and treatment of TB are free." However, there are cases of related hospitals running out of medication or lacking in program quality.

Necessary Background Information:

Tuberculosis can either be DS-TB or DR-TB. First-line drugs are the main or standard line of drugs in DOTS procedures. First-line drugs are used when the patient "has not had TB treatment" before in the past. It can be assumed that patients who have not had TB treatment in the past (and was not transmitted DR-TB from the onset) would not have built up a resistance to TB drugs. Thus, the TB of these first-time patients can be assumed to be susceptible to drugs.

When a patient’s first-line treatment is inadequate (and thus their TB becomes drug resistant), or if DR-TB was transmitted, then the patient must take second-line drugs and take part in DOTS+ or DOTS Plus programs created for DR-TB. It can then be assumed that first-line drugs and DOTS regimens are considered drugs for DS-TB, while second-line drugs and DOTS+/DOTS Plus regimens are considered drugs for DR-TB.

This information is important, because some sources may not explicitly mention costs for the phrase "DS-TB." Instead, they could mention costs for "first-line," "standard," "main," or "DOTS," which are generally assumed by the industry to be drugs for DS-TB.

Free Medication in Government Centers

If treatment is obtained by the government's RNTCP program, "both diagnosis and treatment of TB are free." However, there are cases of related hospitals running out of medication or lacking in program quality.
Although treatment is free in government centers, there is a section of society that is “hesitant to approach government run [centers] for taking medicines.” There are case studies of patients still dying even after going to the government center, which may have led to others calling the centers “cursed” and refusing to go there. Regular medicine stock-outs mean patients are forced to spend money out-of-pocket at private centers.

Overall Costs

Average overall DOTS cost could vary depending on whether the TB was pulmonary or extra pulmonary. Pulmonary tuberculosis had an average cost of $85.40, extra pulmonary had a cost of $164.90, and having both pulmonary and extra pulmonary TB cost $228.30.

Cost Breakdown

One source states that average indirect cost is Rs. 2072 to Rs. 2319. This includes wage loss from not being able to work, as well as costs of additional nutrient supplements and travel.

A standard course of TB drugs cost around Rs. 1000. Another source indicates a patient's direct medical costs were $61/month for DS-TB care (base care), $48/month for improved DS-TB care, and $42/visit in fixed costs. Other indirect costs included $60/month for diagnosis. There could also be pre-treatment costs of $39.74 on average and outpatient costs of $6 per patient. User fees could also account for 80% of a patient's total direct costs.

Conclusion

A list of 8 sources on the treatment cost for drug-susceptible tuberculosis (DS-TB) in India has been compiled in this spreadsheet.
If treatment is obtained by the government's RNTCP program, "both diagnosis and treatment of TB are free." However, there are cases of related hospitals running out of medication or lacking in program quality. Overall, costs for the DOTS program in India was: $85.40 for pulmonary TB, $164.90 for extra pulmonary TB, and $228.30 for both pulmonary and extra pulmonary TB. A cost breakdown includes direct medical costs at $61/month for DS-TB care (base care), $48/month for improved DS-TB care, and $42/visit in fixed costs.
Part
02
of two
Part
02

Drug Resistant TB Treatment Cost in India

A list of 8 sources on the treatment cost for drug-resistant tuberculosis (DR-TB) in India has been compiled in this spreadsheet. A link to the source, source published date, the location of information, and other relevant details have been provided.

For MDR-TB, the expected total treatment cost is $2,310 for "the facility-based model" and $404 for "the home-based model."

A cost breakdown includes MDR-TB drugs costing Rs.1-1.5 lakh. Another source indicates direct medical costs are at $61/month for DS-TB care (base care), $48/month for improved DS-TB care, and $42/visit in fixed costs.

If treatment is obtained by the government's RNTCP program, "both diagnosis and treatment of TB are free." However, there are cases of related hospitals running out of medication or lacking in program quality.

Necessary Background Information

MDR-TB (multi-drug-resistant tuberculosis) is a type of DR-TB.

Tuberculosis can either be DS-TB or DR-TB. When a patient’s first-line treatment is inadequate (and thus their TB becomes drug resistant), or if DR-TB was transmitted, then the patient must take second-line drugs and take part in DOTS+ or DOTS Plus programs created for DR-TB. It can then be assumed second-line drugs and DOTS+/DOTS Plus regimens are considered drugs for DR-TB.

This information is important, because some sources may not explicitly mention costs for the phrase "DR-TB." Instead, they could mention costs for "MDR-TB," "second-line," "DOTS+" or "DOTS Plus," which are generally assumed by the industry to be for DR-TB drugs.

Free Medication in Government Centers

If treatment is obtained by the government's RNTCP program, "both diagnosis and treatment of TB are free." However, there are cases of related hospitals running out of medication or lacking in program quality.
Although treatment is free in government centers, there is a section of society that is “hesitant to approach government run [centers] for taking medicines.” There are case studies of patients still dying even after going to the government center, which may have led to others calling the centers “cursed” and refusing to go there. Regular medicine stock-outs mean patients are forced to spend money out-of-pocket at private centers.

Overall Costs

For MDR-TB, the expected total treatment cost is $2,310 for "the facility-based model" and $404 for "the home-based model." Another source states the total cost of treatment is Rs. 140752.50.

It should be noted that price may fluctuate and MDR-TB treatment could last for over a year. One case study had a patient that spent Rs. 4.8 lakh on average for a 2-year treatment.

Cost breakdown

A patient's direct medical costs for DR-TB were $61/month for DS-TB care (base care), $48/month for improved DS-TB care, and $42/visit in fixed costs. Other indirect costs included $60/month for diagnosis. There could also be pre-treatment costs of $39.74 on average. In a case study, a man named Suresh spent Rs. 1,650 on transportation alone over 6 months to get to the hospital. Another source states MDR-TB drugs cost more than Rs.1-1.5 lakh.

Conclusion

A list of 8 sources on the treatment cost for drug-resistant tuberculosis (DR-TB) in India has been compiled in this spreadsheet. If treatment is obtained by the government's RNTCP program, "both diagnosis and treatment of TB are free." However, there are cases of related hospitals running out of medication or lacking in program quality. For MDR-TB, the expected total treatment cost is $2,310 for "the facility-based model" and $404 for "the home-based model." A cost breakdown includes direct medical costs at $61/month for DS-TB care (base care), $48/month for improved DS-TB care, and $42/visit in fixed costs.
Sources
Sources