An updated literature review concerning the treatment cost of multidrug-resistant tuberculosis

Context: According to a report by the World Health Organization (WHO), there were 1.4 million deaths worldwide in 2015 from tuberculosis (TB), with 3.9% being new cases and 21% being previously treated cases of multidrug-resistant tuberculosis (MDR-TB). Aims: To review the literature concerning the costing analysis situation of MDR-TB treatment. Methods: The study was conducted as a systematic review, with a modified checklist being used as the vital instrument. A search was performed of three databases (PubMed, Cochrane, and Scopus) using the terms (cost OR economic, socioeconomic, expenditure, burden, fee, charge, budget impact) AND (resistance OR multidrug resistance, MDR) AND (tuberculosis OR TB, Mycobacterium tuberculosis) in order to identify relevant articles published from 2006 to the present. Results: A total of 1238 abstracts were identified, and 12 papers were ultimately included in the study. The quantity of the published articles was found to increase during in the period 2008 to 2016. Almost all the studies were based on patients' and healthcare systems' perceptions. The main data sources used were medical establishments and the reports of various relevant organizations. Primary data were used twice as much as secondary data. All the costing types, including direct costs and indirect costs, were mentioned, albeit not with the same frequency. Conclusions: Africa owns one-third of the articles included. Further, it was found that MDR-TB should be treated using ambulatory care rather than hospital-based models. Future research studies should focus on Asia, where drug resistance has proved to be a challenging issue.