Open AccessCost of TB services: approach and summary findings of a multi-country study (Value TB)
Author(s) -
Sedona Sweeney,
Yoko Laurence,
Lucy Cunnama,
Gabriela B. Gomez,
I. Garcia-Baena,
Prajkta Bhide,
T J Capeding,
Susmita Chatterjee,
Ivdity Chikovani,
H. Eyob,
Angela Kairu,
M. Minwyelet Terefe,
Natia Shengelia,
Manoj Toshniwal,
Nuru Saadi,
Eleanor Bergren,
Anna Vassall
Publication year - 2022
Publication title -
the international journal of tuberculosis and lung disease/the international journal of tuberculosis and lung disease. articles traduits en français ...
Language(s) - English
Resource type - Journals
eISSN - 1815-7920
pISSN - 1027-3719
DOI - 10.5588/ijtld.22.0096
Subject(s) - activity based costing , unit (ring theory) , medicine , cost database , unit cost , psychological intervention , inefficiency , cost driver , data collection , data quality , cost estimate , overhead (engineering) , operations management , actuarial science , environmental economics , service (business) , business , computer science , economics , statistics , accounting , marketing , mathematics education , mathematics , management , database , psychiatry , microeconomics , operating system
BACKGROUND: There are currently large gaps in unit cost data for TB, and substantial variation in the quality and methods of unit cost estimates. Uncertainties remain about sample size, range and comprehensiveness of cost data collection for different purposes. We present the methods and results of a project implemented in Kenya, Ethiopia, India, The Philippines and Georgia to estimate unit costs of TB services, focusing on findings most relevant to these remaining methodological challenges. METHODS: We estimated financial and economic unit costs, in close collaboration with national TB programmes. Gold standard methods included both top-down and bottom-up approaches to resource use measurement. Costs are presented in 2018 USD and local currency unit. RESULTS: Cost drivers of outputs varied by service and across countries, as did levels of capacity inefficiency. There was substantial variation in unit cost estimates for some interventions and high overhead costs were observed. Estimates were subject to sampling uncertainty, and some data gaps remain. CONCLUSION: This paper describes detailed methods for the largest TB costing effort to date, to inform prioritisation and planning for TB services. This study provides a strong baseline and some cost estimates may be extrapolated from this data; however, regular further studies of similar quality are needed to add estimates for remaining gaps, or to add new or changing services and interventions. Further research is needed on the best approach to extrapolation of cost data. Costing studies are best implemented as partnerships with policy makers to generate a community of mutual learning and capacity development.