Economic aspects of the burden of tuberculosis in the regions of the Russian Federation

Abstract

The economic burden of disease should be taken into account when assessing the importance of various diseases, especially socially significant ones.): to estimate the economic burden of tuberculosis in regions with high and low burden of tuberculosis. Materials and methods: we assessed direct medical and non-medical, as well as indirect costs according to the official statistics forms for 2021, as well as information on wages according to Rosstat. The share of each cost component in the structure of the economic burden was calculated, as well as the per capita economic burden of tuberculosis as the ratio of the amount of costs to the average annual population. We tested the hypothesis that in subjects with the highest burden of tuberculosis, multidrug-resistant tuberculosis of Mycobacterium tuberculosis and tuberculosis in combination with HIV infection (compared to similar subjects without the highest burden of tuberculosis for these components), there should be an increase in the economic burden of tuberculosis as a result of direct medical costs and indirect costs. Results. For all three options for the burden of tuberculosis, the differences in the structure of expenses in the regions with the highest burden and without it are statistically significant. In the structure of expenses of the regions with the highest burden, indirect costs increase. Conclusions. Reduction of costs for the tuberculosis care with a decreased disease burden occurs due to a decrease in direct medical and indirect costs. The influence of TB/HIV and MDR-TB burden on the growth of direct medical costs has not been identified. The influence of the tuberculosis burden on direct non-medical costs has not been detected. Reduction of any of the components of the burden of tuberculosis as a disease in general, and components of MDR-TB and TB/HIV leads to a reduction in indirect costs. However, since the share of indirect costs in the structure of spending on tuberculosis control is small, this does not play a decisive role.