Modeling the likely economic cost of non-adherence to TB medicines in the Philippines

SETTING: The Philippines has a population of over 90 million people and is one of the 22 highest TB burden countries in the world. OBJECTIVE: To understand the economic cost of non-adherence to TB medicines due to loss to follow up and stock-outs in the Philippines. DESIGN: Data were collected on the economic costs of non-adherence to TB medicines and a model was developed to show those costs under different scenarios. RESULTS: The model showed that as many as 1958 and 233 persons are likely to have died as a result of DS-TB and MDR-TB loss to follow up, respectively, and 588 persons are likely to have died as a result of TB medicine stock outs. The related economic impact in each case is likely have been to be as much as US$72.2 million, US$13.4 million and US$21.0 million, respectively. CONCLUSION: The economic costs of non-adherence to TB medicines due to loss to follow-up and stock-outs represent a significant economic burden for the country and it is likely that the cost of addressing these problems would be much less than this burden and, therefore, a wise investment.