Cost savings associated with video directly observed therapy for treatment of tuberculosis

Details

• Alternative Title:
  Int J Tuberc Lung Dis
• Personal Author:
  Lam, C. K. ; Fluegge, K. ; Macaraig, M. ; Burzynski, J.
• Description:
  OBJECTIVE:
  
  To calculate the per-session and annual direct program costs to implement directly observed therapy (DOT) for tuberculosis treatment and to conduct a cost attribution analysis under varying proportions of DOT utilization for four DOT types.
  
  DESIGN:
  
  Program data covering the study period from September 2014 to August 2015 in New York City (NYC) were used to conduct a retrospective bottom-up micro-costing economic evaluation. For each DOT type, potential per-session and annual program savings were estimated as the cost averted by adopting a uniform distribution of DOT alternatives. Sensitivity analyses explored aggregate cost impacts of unequal distributions.
  
  RESULTS:
  
  There was a total of 38 035 unique DOT visits, of which 12 002 (32%) were clinic-based (CDOT); 15 483 (41%) were field-based (FDOT); 7185 (19%) were live-video (LVDOT); and 3365 (9%) were recorded-video (RVDOT). The per-session direct costs (in 2016 $US) for DOT services delivered during the study period were $8.46 for CDOT; $19.83 for FDOT; $6.54 for LVDOT; and $5.35 for RVDOT. Sensitivity analyses supported the main findings.
  
  CONCLUSIONS:
  
  Significant cost savings were estimated with increased utilization of VDOT. Assuming equivalent treatment adherence, duration, completion, and adverse events across DOT types, RVDOT was the modality that most minimized cost.
  
  
• Subjects:
  Antitubercular Agents Cost Savings Directly Observed Therapy Humans Medication Adherence Retrospective Studies Tuberculosis Videoconferencing
• Source:
  Int J Tuberc Lung Dis. 23(11):1149-1154
• Pubmed ID:
  31718750
• Pubmed Central ID:
  PMC7062606
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHS/United States
• Place as Subject:
  New York City, New York
• Volume:
  23
• Issue:
  11
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:82e8741aad18d582d24d01a87075a75b507a21ae1eb3f443f9381994ac88403f
• Download URL:
  https://stacks.cdc.gov/view/cdc/85755/cdc_85755_DS1.pdf
• File Type:
  [PDF - 189.89 KB ]