The burden of disease, economic costs and clinical consequences of tuberculosis in the Philippines.

OBJECTIVE To provide a multidisciplinary and comprehensive analysis on the impact of tuberculosis (TB) in a high incidence country. METHODS Data from several large scale surveys, carried out between 1997 and 2001 in the Philippines, were used to: (1) perform a burden of disease (BoD) analysis, (2) model the economic costs to society due to lost wages, and (3) determine the clinical outcomes, including the costs of care, for a hypothetical cohort of TB cases. RESULTS Over 500 000 disability-adjusted life years (DALYs) are lost due to illness and premature mortality from TB in the Philippines annually. This is equal to 9% of all years of life lost (YLL) in the Philippines. The combined economic losses due to premature mortality and morbidity total PhP 8 billion (approximately USD $145 million). Clinically, only 28% of patients with incident active TB are diagnosed and successfully treated, while 20% of patients will die without ever being diagnosed and 6% more will die after they are diagnosed because they do not receive adequate care. The costs of treating all expected cases requires between PhP 475-1625 million (approximately USD $8-29 million) annually. CONCLUSION The high burden of disease from TB, large economic losses from mortality and morbidity from TB and the poor clinical outcomes all suggest that there is an urgent need for an increased investment in TB control. The costs of providing this treatment appear to be significantly lower than the current economic losses.