ArticlePloS one2022
Expansion of social protection is necessary towards zero catastrophic costs due to TB: The first national TB patient cost survey in the Philippines.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed.
- Catastrophic costs and impoverishment among tuberculosis-affected households in Nepal: results from a national patient cost survey.Health policy and planning · 2026Article
- Towards universal social protection for people affected by tuberculosis in the Western Pacific Region: a social protection baseline assessment and policy entry points.Tropical medicine and health · 2026Review
- Burden of catastrophic costs, income inequalities and associated factors in Guatemala: First national tuberculosis costs survey, 2023.PloS one · 2026Article
- The impact of social protection interventions on treatment and socioeconomic outcomes of tuberculosis-affected people and households in low income, high burden settings: A systematic review and meta-analysis.PLOS global public health · 2026Article
- Patient mobility and travel distance to receive drug-resistant tuberculosis treatment, and their associations with loss to follow-up in Guizhou Province, China.BMC infectious diseases · 2025Article
- Expanding diagnostic testing for drug-resistant tuberculosis in high burden settings: a cost-effectiveness analysis.BMC public health · 2025Article
- Cost effectiveness analysis of expanding tuberculosis preventive therapy to household contacts aged 5-14 years in the Philippines.Journal of clinical tuberculosis and other mycobacterial diseases · 2025Article
- Does nutritional support contribute to mitigating the financial burden faced by TB-affected households?IJTLD open · 2025Article
- Early cost-effectiveness analysis of a novel rapid diagnostic test for tuberculosis in rural Philippine settings.PLOS global public health · 2025Article
- The catastrophic cost of TB care: Understanding costs incurred by individuals undergoing TB care in low-, middle-, and high-income settings - A systematic review.PLOS global public health · 2025Article
- Cost of TB care and equity in distribution of catastrophic TB care costs across income quintiles in India.Global health research and policy · 2024Article
- Leveraging Global Fund's investments to expand innovative public-private provider engagement in TB.IJTLD open · 2024Article
- Costs incurred by people with co-morbid tuberculosis and diabetes and their households in the Philippines.PloS one · 2024Article
- Article
- Higher loss of livelihood and impoverishment in households affected by tuberculosis compared to non-tuberculosis affected households in Zimbabwe: A cross-sectional study.PLOS global public health · 2024Article
- Determinants of catastrophic costs among households affected by multi-drug resistant tuberculosis in Ho Chi Minh City, Viet Nam: a prospective cohort study.BMC public health · 2023Article
- Costs incurred by people receiving tuberculosis treatment in low-income and middle-income countries: a meta-regression analysis.The Lancet. Global health · 2023Article
- Scoring tools to identify TB patients facing catastrophic costs in the Philippines.Public health action · 2023Article
- The high costs facing TB-affected households in Mali.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2022Article
Corrections and comments
- Erratum issued
Authors and funding
11 authors.
Funding
Abstract
backgroundTuberculosis (TB) is a disease associated with poverty. Moreover, a significant proportion of TB patients face a substantial financial burden before and during TB care. One of the top targets in the End TB strategy was to achieve zero catastrophic costs due to TB by 2020. To assess patient costs related to TB care and the proportion of TB-affected households that faced catastrophic costs, the Philippines National TB Programme (NTP) conducted a national TB patient cost survey in 2016-2017.
methodsA cross-sectional survey of 1,912 TB patients taking treatment in health facilities engaged with the NTP. The sample consists of 786 drug-sensitive TB (DS-TB) patients in urban facilities, 806 DS-TB patients in rural facilities, and 320 drug-resistant TB (DR-TB) patients. Catastrophic cost due to TB is defined as total costs, consisting of direct medical and non-medical costs and indirect costs net of social assistance, exceeding 20% of annual household income.
resultsThe overall mean total cost including pre- and post-diagnostic costs was US$601. The mean total cost was five times higher among DR-TB patients than DS-TB patients. Direct non-medical costs and income loss accounted for 42.7% and 40.4% of the total cost of TB, respectively. More than 40% of households had to rely on dissaving, taking loans, or selling their assets to cope with the costs. Overall, 42.4% (95% confidence interval (95% CI): 40.2-44.6) of TB-affected households faced catastrophic costs due to TB, and it was significantly higher among DR-TB patients (89.7%, 95%CI: 86.3-93.0). A TB enabler package, which 70% of DR-TB patients received, reduced catastrophic costs by 13.1 percentage points (89.7% to 76.6%) among DR-TB patients, but only by 0.4 percentage points (42.4% to 42.0%), overall.
conclusionsTB patients in the Philippines face a substantial financial burden due to TB despite free TB services provided by the National TB Programme. The TB enabler package mitigated catastrophic costs to some extent, but only for DR-TB patients. Enhancing the current social and welfare support through multisectoral collaboration is urgently required to achieve zero catastrophic costs due to TB.
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