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Costs and benefits of improving tuberculosis control: The case of Thailand

Author

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  • Sawert, Holger
  • Kongsin, Sukhontha
  • Payanandan, Vallop
  • Akarasewi, Pasakorn
  • Nunn, Paul P.
  • Raviglione, Mario C.

Abstract

The study evaluates the economic costs and benefits of improving tuberculosis control interventions in Thailand. Provider costs are determined on the basis of marginal treatment costs for varying case numbers and estimates of the cost of required infrastructure changes. Indirect costs are calculated as income lost due to morbidity and premature mortality. An epidemiological model is used to calculate case numbers and mortality under current control conditions and a scenario of improved control. An improved control strategy initially leads to a higher number of detected cases. For longer projection periods, the epidemiological impact of curing a higher proportion of infectious sources results in lower case numbers than those expected without programme improvement. Model simulations show a reduction of total annual case numbers through improved control measures by an average 45% after a simulation period of 20 years. The corresponding societal savings in form of reduced indirect costs from the disease are U.S.$2.4 billion. Reductions in direct provider costs can be expected as a result of decreased numbers of detected cases for longer evaluation periods, as well as a lower proportion of multi-drug-resistant cases. The mean value of predicted savings is U.S.$8.3 million. Since this value is likely to be higher than the required investment in improved infrastructure, net savings can be expected. The result of an uncertainty analysis shows a wide range of potential additional costs or net savings with respect to direct provider costs. Indirect cost calculations show net savings for all parameter values.

Suggested Citation

  • Sawert, Holger & Kongsin, Sukhontha & Payanandan, Vallop & Akarasewi, Pasakorn & Nunn, Paul P. & Raviglione, Mario C., 1997. "Costs and benefits of improving tuberculosis control: The case of Thailand," Social Science & Medicine, Elsevier, vol. 44(12), pages 1805-1816, June.
    • Handle: RePEc:eee:socmed:v:44:y:1997:i:12:p:1805-1816
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    Cited by:

    1. Lucy Cunnama & Gabriela B. Gomez & Mariana Siapka & Ben Herzel & Jeremy Hill & Angela Kairu & Carol Levin & Dickson Okello & Willyanne DeCormier Plosky & Inés Garcia Baena & Sedona Sweeney & Anna Vass, 2020. "A Systematic Review of Methodological Variation in Healthcare Provider Perspective Tuberculosis Costing Papers Conducted in Low- and Middle-Income Settings, Using An Intervention-Standardised Unit Cos," PharmacoEconomics, Springer, vol. 38(8), pages 819-837, August.
    2. Ainsworth, Martha & Beyrer, Chris & Soucat, Agnes, 2003. "AIDS and public policy: the lessons and challenges of `success' in Thailand," Health Policy, Elsevier, vol. 64(1), pages 13-37, April.
    3. Tin Su & Steffen Flessa, 2013. "Determinants of household direct and indirect costs: an insight for health-seeking behaviour in Burkina Faso," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(1), pages 75-84, February.
    4. Yoko Laurence & Ulla Griffiths & Anna Vassall, 2015. "Costs to Health Services and the Patient of Treating Tuberculosis: A Systematic Literature Review," PharmacoEconomics, Springer, vol. 33(9), pages 939-955, September.
    5. Su, Tin Tin & Sanon, Mamadou & Flessa, Steffen, 2007. "Assessment of indirect cost-of-illness in a subsistence farming society by using different valuation methods," Health Policy, Elsevier, vol. 83(2-3), pages 353-362, October.
    6. Anatoly Vinokur & Joana Godinho & Christopher Dye & Nico Nagelkerke, 2001. "The TB and HIV/AIDS Epidemics in the Russian Federation," World Bank Publications - Books, The World Bank Group, number 13965.

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