Work

Out-of-Pocket Expenditure and Catastrophic Cost Incurred by Tuberculosis Patients in Uttar Pradesh, India

Year: 2026

Type: article

Abstract: Background: The National Tuberculosis Elimination Programme (NTEP) aims to eliminate catastrophic costs among people with tuberculosis (TB) and their households by 2025. This study assessed the economic burden of TB among people with TB in Uttar Pradesh, India, with particular focus on out-of-pocket (OOP) expenditure and catastrophic costs. Material and Methods: A cross-sectional survey was conducted among 209 people with TB from 10 districts of Uttar Pradesh using a structured questionnaire. Information related to household income, direct medical expenditure, indirect costs, and wage loss was collected. Expenditure data were summarized using median, interquartile range, mean, standard deviation, and proportions. Month-wise expenditure data were further analyzed using a Moving Average approach to estimate expenditure trends during the standard 6-month treatment period. Results: Approximately 19.5% of people with TB experienced catastrophic expenditure, with agricultural laborers (33%) and housewives (31%) disproportionately affected. The median catastrophic expenditure among affected households was Rs. 37,750/-. Indirect costs, particularly wage loss, contributed substantially to the overall financial burden. While nearly half of the participants reported no direct OOP expenditure, some households incurred very high treatment-related costs. The projected indirect expenditure per patient during the 6-month treatment period was approximately Rs. 5,000/-, of which wage loss accounted for nearly Rs. 4,000/-. Conclusions: Although direct treatment costs under NTEP were relatively low, indirect costs continued to impose substantial economic burden on affected households. Strengthening financial risk protection measures, wage compensation mechanisms, and patient-centered support strategies may help reduce catastrophic expenditure associated with TB care.

Source: Indian Journal of Community Medicine

DOI: 10.4103/ijcm.ijcm_433_25

Authors: Manish Kumar Singh, Debasis Pandit, Arkaprabha Sau, Srishti Dixit, Ashok Bhardwaj

Institution: Dr. Ram Manohar Lohia Institute of Medical Sciences

Language: English

Topic: Healthcare Systems and Reforms

Subfield: Finance

Field: Economics, Econometrics and Finance

Domain: Social Sciences

SDGs: No poverty, Good health and well-being, Decent work and economic growth

Open Access status: gold

Estimated APC paid: $80