A recent study led by Dr Susmita Chatterjee from The George Institute of Global Health, India, has shed light on the long-term economic impact of tuberculosis (TB) on patients, even a year after the end of treatment. 

The study has also shown that India still has a long way to go to reach the goal of zero catastrophic costs for all patient groups, as stated in the END TB Strategy.  As an outcome of the understanding, the scientists have recommended a few strategic solutions to reduce the catastrophic impacts of TB in India. 

Reducing delays in diagnosis and treatment initiation (patients visit on average 12 healthcare providers before getting diagnosed with TB) can reduce the costs associated with TB treatment, its aftermath, and its related economic consequences.

Creating awareness about the symptoms of TB in the community and availability of free diagnostic and treatment facilities in the government sector is crucial in this regard, they say.

They also recommend that policy changes must ensure that the livelihood of TB patients is not disrupted and hence, the changes should include the provision of job security, additional food support, better management of direct benefit transfers, and improved medical insurance coverage.

The total cost of TB treatment from the onset of symptoms to one-year post-treatment ranges from Rs 26,500 – 30,500 per patient despite free diagnosis and treatment provided by the government. Of this, 32% to 44% of costs were incurred in the pre-treatment phase (i.e., from the initiation of TB symptom till initiation of treatment), while 6%-7% were incurred in the post-treatment phase. 

The study emphasised that the economic impact of TB does not end with the completion of the TB treatment: it continues long after.

“Interestingly, our study indicated that financial insecurity affects patients across all categories,” said Dr Susmita Chatterjee.