Free Content Cost and cost-effectiveness of a public-private mix project in Kannur District, Kerala, India, 2001–2002

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Abstract:

BACKGROUND: Little is known yet about the cost-effectiveness of public-private mix (PPM) collaborations for the delivery of tuberculosis (TB) diagnostic and treatment services.

DESIGN: We evaluated the cost and cost-effectiveness of a PPM project targeting private laboratories in Kannur district, India, from the perspective of the Revised National TB Control Programme (RNTCP). We estimated the cost per provider recruited and retained, the cost per additional patient notified under various effectiveness scenarios and the cost per additional patient successfully treated. Intervention cost data were abstracted from RNTCP records. Treatment costs were estimated based on RNTCP case management protocols.

RESULTS: The annual total estimated cost of the project was US$8712–$11611. The cost per private provider recruited varied between US$22 and US$54. The cost per additional pulmonary TB patient privately diagnosed was US$14–$18. In the most conservative scenario, the cost per additional patient notified was US$29–$36. The cost per new acid-fast bacilli-positive patient successfully treated was US$47–$51. Higher notification rates would improve cost-effectiveness.

CONCLUSIONS: Comparisons with public sector diagnostic costs are required to determine if this intervention remains economically attractive to the public health care system at different activity levels and to determine the supplemental resources needed if scale-up is pursued.

Keywords: India; cost-effectiveness; public-private mix; tuberculosis

Document Type: Regular Paper

Affiliations: 1: International Research and Programs Branch, Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA 2: District Health Office, Kannur, India 3: Office of the World Health Organization Representative to India, New Delhi, India 4: International Research and Programs Branch, Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA; and Office of the World Health Organization Representative to India, New Delhi, India 5: Central Tuberculosis Division, Directorate General of Health Services, Ministry of Health and Family Welfare, New Delhi, India

Publication date: July 1, 2007

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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