The affordability for patients of a new universal MDR-TB coverage model in China

Int J Tuberc Lung Dis. 2016 May;20(5):638-44. doi: 10.5588/ijtld.15.0413.

Abstract

Background: China has piloted a new model of universal coverage for multidrug-resistant tuberculosis (MDR-TB), designed to rationalize hospital use of drugs and tests and move away from fee-for-service payment towards a standard package with financial protection against catastrophic health costs.

Objective: To evaluate the affordability to patients of this new model.

Design: This was an observational study of 243 MDR-TB cases eligible for enrolment on treatment under the project. We assessed the affordability of the project from the perspective of households, with a focus on catastrophic costs.

Results: Of the 243 eligible cases, 172 (71%) were enrolled on treatment; of the 71 cases not enrolled, 26 (37%) cited economic reasons. The 73 surveyed cases paid an average of RMB 5977 (US$920) out-of-pocket in search costs incurred outside the pilot model. Within the pilot, they paid another RMB 2094 (US$322) in medical fees and RMB 5230 (US$805) in direct non-medical costs. Despite 90% reimbursement of medical fees, 78% of households experienced catastrophic costs, including indirect costs.

Conclusion: The objectives of the pilot model are aligned with health reform in China and universal health coverage globally. Enrollment would almost certainly be higher with 100% reimbursement of medical fees, but patient enablers will be required to truly eliminate catastrophic costs.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antitubercular Agents / economics*
  • Antitubercular Agents / therapeutic use*
  • Child
  • Child, Preschool
  • China
  • Cost Control
  • Delivery of Health Care / economics*
  • Delivery of Health Care / legislation & jurisprudence
  • Drug Costs* / legislation & jurisprudence
  • Female
  • Financing, Personal / economics
  • Health Care Reform / economics
  • Health Expenditures* / legislation & jurisprudence
  • Humans
  • Infant
  • Infant, Newborn
  • Insurance, Health / economics*
  • Insurance, Health / legislation & jurisprudence
  • Insurance, Health, Reimbursement
  • Male
  • Middle Aged
  • National Health Programs / economics*
  • National Health Programs / legislation & jurisprudence
  • Pilot Projects
  • Program Evaluation
  • Tuberculosis, Multidrug-Resistant / diagnosis
  • Tuberculosis, Multidrug-Resistant / drug therapy*
  • Tuberculosis, Multidrug-Resistant / economics*
  • Universal Health Insurance / economics*
  • Universal Health Insurance / legislation & jurisprudence
  • Young Adult

Substances

  • Antitubercular Agents