Cost of treatment for multidrug-resistant tuberculosis in South Korea

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.