TB economic evaluation & survey

The TB economics and finance team in collaboration with partners across countries, academia and across WHO supports WHO’s member states to collect, evaluate and introduce economic evidence into TB prevention, diagnosis and care policy. This work is accomplished by disseminating methods, standards and tools as well as capitalizing and expanding country capacity, and by providing technical assistance to countries to produce and use economic evidence to advance in the End TB strategy and UHC agenda.

Three main areas in TB economic evaluation & survey:

1. Measuring costs borne by TB-affected households
2. Measuring costs of delivering TB services at the facility
3. TB economic modelling

Guidance and tools links in this page are intended for use by Ministries of Health and/or research partners wishing to conduct economic evaluation to support public policy and strategy.

The World Health Organization (WHO) End TB Strategy includes the target that no tuberculosis (TB) patients or their households face catastrophic costs (including direct medical expenditures, non-medical expenditures and income losses) because of TB disease.

Monitoring of progress towards this target can inform monitoring of progress towards universal health coverage (UHC); however, this target should not be confused or directly compared with the Sustainable Development Goal (SDG) UHC indicator for financial protection from health care expenditures among the general. Our team at WHO provides global monitoring of the End TB indicator and periodically synthesizes results and lessons learned.

WHO has established standard methods for conducting a national survey to assess the direct and indirect costs incurred by people with TB and their households (TB patient cost surveys) as well as to assess the proportion of households incurring catastrophic costs (defined as total costs equivalent to 20% or more of annual household income or expenditure).

Guidance, data collection and analysis tools can also be adapted in the context of other economic evaluation research where costs of TB interventions are assessed from several perspectives (provider, patient, community, societal) including the patient perspective.

The best way to measure the cost of delivering TB services in a country is through costing studies based on recommended methods, including primary data collection at national and local levels.

The Costing guidelines for tuberculosis interventions and associated Value TB costing tool suite (which forms part of the costing guidelines) provide TB planners and operational research partners with standards and tools to measure the costs of delivering TB services at the facility level (i.e. unit cost of TB services).

The guidelines provide practical advice on how to collect cost data, perform analysis, use and disseminate data. The tools can be used to estimate the costs of delivering TB services nationally based on a nationally representative sample of facilities. They can also be used and adapted to estimate the costs of introducing new and emerging TB technologies to inform resource allocation between different TB interventions.