Patient medical costs for tuberculosis treatment and impact on adherence in China: a systematic review

Qian Long; Smith, Helen; Tuohong Zhang; Shenglan Tang; Garner, Paul
January 2011
BMC Public Health;2011 Supplement 4, Vol. 11 Issue Suppl 4, p393
Academic Journal
Background: Charging for tuberculosis (TB) treatment could reduce completion rates, particularly in the poor. We identified and synthesised studies that measure costs of TB treatment, estimates of adherence and the potential impact of charging on treatment completion in China. Methods: Inclusion criteria were primary research studies, including surveys and studies using qualitative methods, conducted in mainland China. We searched MEDLINE, PUBMED, EMBASE, Science Direct, HEED, CNKI to June 2010; and web pages of relevant Chinese and international organisations. Cost estimates were extracted, transformed, and expressed in absolute values and as a percentage of household income. Results: Low income patients, defined at household or district level, pay a total of US$ 149 to 724 (RMB 1241 to 5228) for medical costs for a treatment course; as a percentage of annual household income, estimates range from 42% to 119%. One national survey showed 73% of TB patients at the time of the survey had interrupted or suspended treatment, and estimates from 9 smaller more recent studies showed that the proportion of patients at the time of the survey who had run out of drugs or were not taking them ranged from 3 to 25%. Synthesis of surveys and qualitative research indicate that cost is the most cited reason for default. Conclusions: Despite a policy of free drug treatment for TB in China, health services charge all income groups, and costs are high. Adherence measured in cross sectional surveys is often low, and the cumulative failure to adhere is likely to be much higher. These findings may be relevant to those concerned with the development and spread of multi-drug resistant TB. New strategies need to take this into account and ensure patient adherence.


Related Articles

  • Adherence to COPD therapy lowers resource use, costs in US.  // PharmacoEconomics & Outcomes News;11/13/2010, Issue 616, p8 

    The article discusses research on the link between lower daily dosing frequency of therapies for chronic obstructive pulmonary disease (COPD) and patient adherence and health care costs in the U.S., published in the 2010 issue of "Respiratory Medicine."

  • Different screening strategies (single or dual) for the diagnosis of suspected latent tuberculosis: a cost effectiveness analysis. Pooran, Anil; Booth, Helen; Miller, Robert F.; Scott, Geoff; Badri, Motasim; Huggett, Jim F.; Rook, Graham; Zumla, Alimuddin; Dheda, Keertan // BMC Pulmonary Medicine;2010, Vol. 10, p7 

    Background: Previous health economic studies recommend either a dual screening strategy [tuberculin skin test (TST) followed by interferon-γ-release assay (IGRA)] or a single one [IGRA only] for latent tuberculosis infection (LTBI), the former largely based on claims that it is more...

  • COPD impact model shows £1.2bn cost to UK economy.  // British Journal of Healthcare Computing & Information Management;Jul2010, p22 

    The article reports that chronic obstructive pulmonary disease (COPD), mainly caused due to smoking, is expected to become the third biggest cause of death by 2020. It states that the COPD model calculated that the economic burden on Great Britain is 1.2 billion pounds per annum, which includes...

  • The price of noncompliance.  // Family Practice Management;Feb2002, Vol. 9 Issue 2, p23 

    Reports the influence of increased pharmaceutical costs and co-payments in drug noncompliance in the United States.

  • Adherence is a pricey problem. M. A. // Medical Marketing & Media;Jun2010, Vol. 45 Issue 6, p11 

    The article reports on the claims of an Express Scripts study that the medical costs of patient non-adherence to therapy costs 106 billion dollar each year in the U.S.

  • Benefits of dosette use. Arthur, Annette // GP: General Practitioner;4/4/2008, p39 

    The article reports on the implication of monitored-dosage systems or dosettes on the development of drug compliance in patients. Dosettes can improve drug compliance for patients and increase their dispensary income. Dosettes are set to cover the set-up cost of purchasing the dosette cards and...

  • Screening for tuberculosis: the port of arrival scheme compared with screening in general practice and the homeless. Bothamley, G. H.; Rowan, J. P.; Griffiths, C. J.; Beeks, M.; McDonald, M.; Beasley, E.; van den Bosch, C.; Feder, G. // Thorax;Jan2002, Vol. 57 Issue 1, p45 

    Background: Tuberculosis is increasing in London, especially in those recently entering the UK from an area of high incidence. Screening through the port of arrival scheme has a poor yield and has been considered discriminatory.Methods: A study was undertaken to compare...

  • The cost structure of lung tuberculosis in Germany. Diel, Roland; Rappenhöner, Bernhard; Schaberg, Tom // European Journal of Health Economics;Sep2004, Vol. 5 Issue 3, p243 

    Although the total number appears to be decreasing, 7,886 new cases of tuberculosis (TB) were reported in Germany in 2001. Previous American publications reveal considerable differences in the costs caused by the disease. On the basis of the therapy guidelines of the Deutsches Zentralkomitee zur...

  • Is routine histological evaluation of pediatric hernial sac necessary? Siddiqui, Khurram; Nazir, Zafar; Ali, Syed Sohail; Pervaiz, Shahid // Pediatric Surgery International;Feb2004, Vol. 20 Issue 2, p133 

    Advocates of routine histological examination of hernial sac recommend it for surgical quality assurance, to report injuries to the vas deferens, and to detect occult malignant and benign diseases such as tuberculosis. However, the value of this routine examination is debated in this era of cost...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics