ABSTRACT
SETTING: From 1993 through 1998, 1846 cases of multidrug-resistant tuberculosis (MDR-TB) were reported in the United States. Costs associated with MDR-TB are likely to be much higher than for drug-susceptible tuberculosis due to longer hospitalization, longer treatment with more expensive and toxic medications, greater productivity losses, and higher mortality. OBJECTIVE: To measure the societal costs of patients hospitalized for MDR-TB. DESIGN: We detailed in-patient costs for 13 multidrug-resistant patients enrolled in a national study. We estimated costs for physician care, out-patient treatment, and productivity losses for survivors and for deceased patients. RESULTS: In-patient costs averaged US$25,853 per person and $1036 per person-day of hospitalization. Outpatient costs per person ranged from $5744 to $41,821 (average $19028, or $44 a day). Direct medical costs averaged $44,881; indirect costs for those who survived averaged $32,964, and indirect costs for those who died averaged $686,381 per person. Total costs per person ranged from $28,217 to $181492 (average $89,594) for those who survived, and from $509490 to $1278066 (average $717555) for those who died. CONCLUSION: The societal costs of MDR-TB varied, mostly because of length of therapy (including in-patient), and deaths during treatment.
