Abstract:

Objective The purpose of this study is to measure the cost of treatment for drug-resistant tuberculosis under different treatment options and price sources.Methods Based on the recommended treatment plans by China’s Multidrug-Resistant Pulmonary Tuberculosis Clinical Path (2012 edition) and WHO Drug-Resistant Tuberculosis Treatment Guide (2018 edition), the treatment costs of drug-resistant tuberculosis were measured under the market price in China Mainland and the WHO centralized purchase price, respectively, and the catastrophic health expenditure (refers to the proportion of household cash payment medical expenses to household consumption expenditure ≥40%) was used to evaluate drug affordability of patients.Results Under the treatment plan and market price in China (2012 edition), the total cost range of drug-resistant tuberculosis patients was 19500-12700 million yuan/person, and the self-paying interval was 5322-78482 yuan/person. Among them, under some treatment programs, only the expenditure of drugs caused catastrophic health expenditure. The proportion of health expenditure in urban residents ranged from 2.19% to 32.25%, and it ranged from 5.87% to 86.60% in rural residents. Under the same treatment plan (2018 WHO Guide), the self-paying interval of drug-resistant tuberculosis patients under the market purchase price in China Mainland was 745000-770000 yuan/person, and all treatment programs had reached catastrophic health expenditure, while the patient’s self-paying interval under the WHO centralized purchase price was 80700-95900 yuan/person.Conclusion Compared with the WHO centralized purchase price, domestic second-line anti-tuberculosis drugs are more expensive, and the drug-resistant tuberculosis treatment imposes a heavy economic burden on patients, especially in rural area.

Key words: Tuberculosis, Drug resistance, Fees, pharmaceutical, Medical indigency