Economic Cost of Non-Adherence to TB Medicines Resulting from Stock-Outs and Loss to Follow-Up in the Philippines (SIAPS Technical Highlight)
(2016; 4 pages)


One of the key elements of successful tuberculosis (TB) control programs is adherence to treatment, and this is a cornerstone of most international and national policies and guidelines. Non-adherence is often due to patient-related factors, but can also be a result of provider issues, such as stock-outs of TB medicines. Non-adherence results in increases in length and severity of illness, deaths, disease transmission, and drug resistance. These have economic consequences in terms of costs and loss of income for patients and their families and also costs to the health system.

Non-adherence is commonly due to treatment interruption, which may be for short intermittent periods of a few days or for longer periods of weeks or months, and may even end up as com-plete discontinuation of treatment. Interventions to prevent treatment interruption are aimed at both patients and providers. On the provider side, actions include ensuring proper prescribing prac-tices and management of side effects, providing good quality medicines, and preventing stock-outs. On the patient side, these include interventions to encourage patients to continue treatment even when they feel better, use medicines as directed, and remove barriers such as transport costs. These actions are believed to be a good investment, but the economic savings have not been well and clearly defined.

At the request of the National Tuberculosis Control Pro-gram (NTP) and USAID, a study was conducted to determine the health, mortality, and economic impact of stock-outs and Loss to Follow-Up (LTFU) to justify greater investment in addressing these challenges.

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