Costs to Patients with Tuberculosis Treated under Dots Programme

Background: The economic burden of TB in India is enormous as TB perpetuates and exacerbates poverty. Revised National Tuberculosis Control Programme (RNTCP) based on DOTS strategy is currently being implemented in India. The purpose of this study is to estimate the costs incurred by tuberculosis patients treated under RNTCP in a district in Tamilnadu where services are decentralized for diagnosis and treatment. Method: In all, 455 patients registered under RNTCP between June and December 2000, in Tiruvallur district were interviewed to collect the following information: Demographic, socio-economic characteristics of patients, expenditure incurred due to illness and effect of illness on employment. Based on the data collected, various costs (direct medical, nonmedical, indirect and total costs incurred on account of tuberculosis before and during treatment) were estimated. In addition Standard of Living Index (SLI) was calculated for patients. Results: Of 455 patients, 62% had low SLI. The median direct, indirect and total costs for 343 patients who successfully completed treatment were as follows: pre treatment direct costs were Rs 340, during treatment direct costs Rs 100; more than 50% of patients did not incur any indirect costs in both pre treatment and during treatment periods and overall total costs were Rs 1398. About 12% of patients lost more than 60 workdays and after completing treatment, 88% returned to work. Conclusion: For patients registered under RNTCP in Tiruvallur district in Tamilnadu, the findings that the total patient costs were Rs 1398/and also the patients returned to work early establishes the economic benefits to patients treated under DOTS and lend support to rapid expansion of DOTS programme, particularly in low-income countries.