The economic burden of tuberculosis in Indonesia.

SETTING Indonesia has a high prevalence of tuberculosis (TB) and is one of the 22 countries with the highest TB burdens in the world. OBJECTIVE To understand the economic burden of TB in Indonesia. DESIGN TB data for 2015 were combined with cost data using a simple type of cost-benefit analysis in a decision tree model to show the economic burden under different scenarios. RESULTS In Indonesia, there were an estimated 1 017 378 new active TB cases in 2015, including multidrug-resistant TB. It is estimated that 417 976 of these cases would be treated and cured, 160 830 would be unsuccessfully treated and would die, 131 571 would be untreated and would achieve cure spontaneously, and 307 000 would be untreated and would die. The total economic burden related to treated and untreated cases would be approximately US$6.9 billion. Loss of productivity due to premature death would be by far the largest element, comprising US$6.0 billion (discounted), which represents 86.6% of the total cost. Loss of productivity due to illness would be US$700 million (10.1%), provider medical costs US$156 million (2.2%), and direct non-medical costs incurred by patients and their households US$74 million (1.1%). CONCLUSION The economic burden of TB in Indonesia is extremely high. Detecting and treating more cases would result not only in major reductions in suffering but also in economic savings to society.