Cost of treatment for multidrug‐resistant tuberculosis in South Korea

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Abstract
Objective and background:  Costs associated with multidrug‐resistant tuberculosis (MDR‐TB) are higher than those associated with drug‐susceptible TB because of the higher prices of second‐line anti‐TB drugs, the prolonged duration of treatment, greater productivity loss and higher mortality. The aim of this study was to estimate the cost of treatment for MDR‐TB according to the treatment strategy and prognosis in South Korea.Methods:  We estimated the direct (medical and non‐medical) and indirect cost for the treatment of MDR‐TB according to the treatment strategies and prognosis: in medically treated, surgically treated and deceased patients groups. The same analyses were undertaken for drug‐susceptible TB for comparison. The patients with MDR‐TB or drug‐susceptible TB were randomly selected from the TB cohort of Seoul National University Hospital, Seoul, South Korea.Results:  Direct costs per person were US$4000 (US$2527–4841) in the medically treated group, US$17 457 (US$10 133–26 418) in the surgically treated group and US$33 362 (US$25 386–40 338) in the deceased group. Total costs per person were US$15 856 (US$10 752–38 421), US$47 159 (US$20 587–77 622) and US$478 357 (US$257 377–777 778), respectively. For the patients with drug‐susceptible TB, the total cost ranged from US$1680 to US$7637 (median US$2166).Conclusions:  The cost for the treatment of MDR‐TB is seven to 22 times that of managing the drug‐susceptible TB in South Korea. Considering the high cost, transmissibility and considerable fatality of MDR‐TB, there is a need to provide specific separate funding for multidrug‐resistant tuberculosis.