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Cost-effectiveness analysis of the russian treatment scheme for tuberculosis versus short-course chemotherapy: results from Tomsk, Siberia.

SETTING
Tomsk Oblast, Siberia.


OBJECTIVE
To assess the cost-effectiveness of individualised Russian treatment and short-course chemotherapy (SCC) regimens for new WHO Category I tuberculosis patients.


DESIGN
Analysis of costs incurred by the provider, the household and society as a whole for both treatment approaches, and a sensitivity analysis for SCC with hospitalisation for 2 weeks (patients theoretically at low risk of defaulting) and 2 months (patients theoretically at risk of defaulting). Outcomes were measured as cost per case cured and year of life saved, with cure rates based on a locally conducted trial.


RESULTS
The cost per cure using the individualised Russian treatment was US $2,295, vs. US $1,901 when using SCC. The costs per year of life saved were respectively US $123 and US $103. The cost per cure was US $1,457 for SCC with 2 months hospitalisation and US $556 for SCC with 2 weeks hospitalisation, with costs per year of life saved of US $79 and US $30, respectively.


CONCLUSION
Major financial savings for both the provider and the household, with cure rates similar to those obtained with the Russian treatment scheme, can be achieved in Tomsk when embarking on SCC with 2 weeks and 2 months hospitalisation.