Table 3

Costs of Digital Adherence Technologies for Tuberculosis Treatment Support, 2018–2021

Ntwali Placide Nsengiyumva, Amera Khan, Maricelle Ma. Tarcela S. Gler, Mariecef L. Tonquin, Danaida Marcelo, Mark C. Andrews, Karine Duverger, Shahriar Ahmed, Tasmia Ibrahim, Sayera Banu, Sonia Sultana, Mona Lisa Morales, Andre Villanueva, Egwumo Efo, Baraka Onjare, Cristina Celan, and Kevin Schwartzman

Author affiliations: McGill International Tuberculosis Centre and Research Institute, McGill University Health Centre, Montreal, Quebec, Canada (N.P. Nsengiyumva, K. Schwartzman); Stop TB Partnership, Geneva, Switzerland (A. Khan); De La Salle Medical and Health Sciences Institute, Makati City, Philippines (M.M.T.S. Gler, M.L. Tonquin, D. Marcelo); Health Through Walls, Port au Prince, Haiti (M.C. Andrews, K. Duverger); icddr,b, Dhaka, Bangladesh (S. Ahmed, T. Ibrahim, S. Banu, S. Sultana); KNCV, Manila, Philippines (M.L. Morales, A. Villanueva); KNCV, Dar es Salaam, Tanzania (E. Efo, B. Onjare); Center for Health Policies and Studies, Chisinau, Moldova (C. Celan)

Main Article

Digital adherence technologies compared with directly observed therapy costs*

Cost	99DOTS sites, US$			VOT sites, US$
	Bangladesh, healthcare facility	Philippines, health care facility	Tanzania, home	Haiti, prison				Philippines, healthcare facility or home
					Moldova, health facility
					DS-TB	DR-TB	All TB
Crude estimate for DOT cost for the standard of care derived from the costing tool
Hourly wage of person offering DOT support	0.83	1.40	0.00	4.60	11.20	11.20	11.20	2.88
Duration of DOT visit, min	45	45	0	45	15	15	15	2
Total per patient cost
DOT cost from study data	74	176	0	414	336	504	427	17
DOT cost from the literature	36 (22)	155 (23)	89 (24)	49 (25)				166 (23)
Annuitized cost of DAT	81	92	163	1,060	172	254	211	495
Variable DAT costs only	60	83	160	702	151	222	185	247
Incremental per patient cost for the DAT versus standard of care
Study data as comparator†	7	–84	163	646	–164	–250	–216	478
Prior published data as comparator‡	45	–63	74	1,011	–	–	–	329
Incremental per patient cost for the DAT using variable costs only versus standard of care, assuming fixed costs are already sunk
Study data as comparator†	–14	–93	160	288	–185	–282	–242	230
Prior published data as comparator‡	24	–72	71	653	–	–	–	81

*DAT, digital adherence technologies; DOT, directly observed therapy; –, no prior published data available for comparison. †Negative incremental costs indicate savings for the DAT relative to standard of care. ‡There is no available literature documenting the cost of DOT in Moldova; therefore, we did not calculate incremental costs when published literature was the comparator.

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Page created: October 31, 2023

Page updated: December 20, 2023

Page reviewed: December 20, 2023

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