Researchers Find TB-Prevention Therapy Is Cost-Effective Option

University of Alabama at Birmingham (UAB) researchers have found that the cost of preventive antibiotic tuberculosis (TB) therapy for patients infected by human immunodeficiency virus (HIV) is generally less expensive than the reported cost of treating newly confirmed TB cases.

The study, published in the International Journal of Tuberculosis and Lung Disease this summer, relied on treatment-cost estimates from previous research studies and data collected by members of the study's research team at a TB treatment site in Cambodia.

"We completed this study to provide health-program managers cost and cost-effectiveness data on components of a comprehensive package of HIV care. This data is essential to help establish feasible and effective ways to manage patients with human immunodeficiency virus infection and tuberculosis in a developing country," said Bryce Sutton, PhD, an economist in the UAB School of Business and one of the study's co-investigators.

The research found that the cost of preventing a single case of TB with intensive screening and preventive treatment with antibiotics in HIV-infected patients prior to their exposure to the disease was approximately $950. Compare that to a cost range of $900 to $1,500, which is the previously reported range for treating a new smear-positive TB case in a developing country setting after adjusting for inflation.

"Our analysis showed that the costs associated with screening and preventive treatment for TB among HIV-infected patients was comparable to the cost related to treating a patient with a newly confirmed case of TB," Sutton said. "When you factor in observed high adherence rate to treatment and other cost savings such as averted productivity losses that come with stopping TB's spread through the preventive care, we believe that this type of integrated care offers a potential savings to governments and healthcare agencies."

Sutton said preventing the spread of TB goes beyond cost-savings and can positively affect local, regional and national developing economies."Diseases like tuberculosis in a developing country setting can be catastrophic both in terms of health and the financial burden it places on families," he said. "Often other family members stop working to become caretakers; children and young adults may be forced to enter the workforce to pay for expenses and forgo receiving an education, which can start a cycle of poverty. These are important economic factors that support the adoption of preventive-care TB policies."

Former UAB professor of infectious diseases Michael Kimerling, MD, is the study's co-investigator. Former UAB graduate researchers Phalkun Chheng and Mayra Arias and M.T. Eang from the National Tuberculosis and Leprosy Control (CENAT) Phnom Penh, Cambodia, also are on the research team.

Data used in the study were collected at one of four pilot treatment sites facilitated in Cambodia through the UAB-led Gorgas Tuberculosis Initiative, which was created to establish feasible and effective ways to manage patients with HIV and TB.