Cost for tuberculosis care in developed countries: which data for an economic evaluation?

Tuberculosis (TB) seems to be eradicated in developed countries. However, current migration flows and increasing use of immunosuppressive and biologic drugs for rheumatic diseases are increasing the risk of latent TB and TB onset for citizens of developed countries. Because little is known about the economic burden of TB in developed countries, we set out to describe the order and dimension of the costs of TB care in developed countries. A review of the literature indicated that the cost for anti-TB therapy is about $2000 US per patient. Costs of drugs associated with standard therapy for active TB [2HRZE/4HR, i.e., 2 months of isoniazid (H), rifampin (R), pyrazinamide (Z), and ethambutol (E), followed by 4 months of HR] are about $600. Standard therapy for latent TB care costs about $80 for 9H and $256 for 4R, respectively. However, these data are very limited because of the horizon of analysis and because data are strongly localized. It can be concluded that in developed countries, available data on TB care costs are insufficient for detailed analysis of the economic burden of TB.