Economic evaluation of tuberculosis control in Armenia : a cost-effectiveness analysis of the WHO strategy / prepared by W.J. Meerding
AbstractAn economic evaluation was made of the WHO tuberculosis control strategy in Armenia. The evaluation concentrated on newly detected smear-positive patients. This strategy, characterized by rapid case detection, mandatory hospitalization during the intensive phase of treatment and shortened treatment duration, was compared with the strategy formerly employed, characterized by extensive hospitalization and lengthy treatment. Data on diagnostic and treatment procedures regarding TB patients, as well as costs of diagnostic procedures, drug regimens, hospital days and outpatient visits, were gathered and compared with official guidelines for TB treatment. The strategy implemented according to WHO guidelines (referred to hereafter as 'the WHO strategy') turned out to be more cost-effective than the strategy formerly employed for TB control in Armenia (referred to hereafter as 'the old strategy'), with medical costs amounting to $176 and $280 respectively per cured patient. This is mainly due to the shortened treatment period and shorter length of hospitalization, although hospitalization rates are much higher in the WHO strategy, combined with higher cure rates (72% on average compared with 65% in the old strategy). Even when relatively favourable figures were assumed for the old strategy, the WHO strategy was slightly more cost-effective. The use of diagnostic procedures and related costs in patient follow-up were difficult to measure empirically in both strategies. Data from several TB dispensaries and the main TB hospital indicate a decreasing use of smears and X-rays per patient since the introduction of the WHO strategy. A more efficient use of diagnostic procedures in the WHO strategy is likely, but could not be proven by empirical data. The main outcome of the evaluation, therefore, might be conservative rather than progressive
Meerding, W.J & World Health Organization. Regional Office for Europe. (1998). Economic evaluation of tuberculosis control in Armenia : a cost-effectiveness analysis of the WHO strategy / prepared by W.J. Meerding. Copenhagen : WHO Regional Office for Europe. http://www.who.int/iris/handle/10665/108086
DescriptionEUR/ICP/CMDS 04 03 02
Gov't Doc #EUR/ICP/CMDS 04 03 02
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Extensive review of TB prevention, care and control services Tuberculosis programme in Armenia, 21 April - 4 May 2011. edited by Masoud Dara, Zaruhi Mkrtchyan and Gayane Ghukasyan World Health Organization. Regional Office for Europe; Dara, Masoud; Mkrtchyan, Zaruhi; Ghukasyan, Gayane (2012)