NEW DELHI: Tuberculosis (TB) patients in India are facing catastrophically high costs due to lost productivity and hospitalisation, according to a study by the Indian Council of Medical Research (ICMR).
The study led by researchers from the ICMR-National Institute of Epidemiology (ICMR-NIE), in Chennai, showed that TB continues to pose a significant social and economic burden to households.
“Persons with TB in India incur high costs mainly due to lost productivity and hospitalisation. Nearly half of them experience catastrophic costs, especially those from poorer economic quintiles, ” said the team led by Kathiresan Jeyashree, a scientist at ICMR-NIE.
“Despite free diagnosis and care under the National TB Elimination Programme (NTEP), individuals often experience significant out-of-pocket expenditure and lost productivity, causing financial catastrophe, ” he added.
The study, published in the Global Health Research and Policy journal, estimated the costs incurred by 1, 407 persons with TB during their care and also identified the factors associated with the costs.
The cross-sectional study measured total patient costs through direct medical, non-medical, and indirect costs.
Catastrophic costs were defined as expenditures on TB care more than 20 per cent of the annual household income.
The mean age of the patients was 40.8 years, and 865 (61.5 per cent) were male, and 786 (55.9 per cent) were economically active.
Thirty-four (2.4 per cent) had drug-resistant TB (DRTB), and 258 (18.3 per cent) had been hospitalised for TB.
Direct costs accounted for 34 per cent of the total costs. TB patients less than 60 years of age, without health insurance, and those hospitalised for the condition experienced higher median costs.
About 45 per cent of TB patients experienced catastrophic costs.
Notably, hospitalised TB patients and those notified from the private sector were more likely to incur catastrophic costs.
The study called for enabling early notification of TB, and "expanding the coverage of health insurance schemes to include persons with TB.
"Implementing TB-sensitive strategies to address social determinants of TB may significantly reduce catastrophic costs incurred by persons with TB, ” Jeyashree said.