Counting the Cost of TB in Europe

This post first appeared on the RESULTS UK blog on August 20.

On August 15, the European Respiratory Society released a brief report calculating the cost of tuberculosis in the EU. The headline figures are striking. TB costs the EU over €500million every year in direct and indirect costs, and an estimated €5.3 billion a year in lost productivity.

The €500 million described as direct and indirect costs include medication, laboratory, hospitalisation and outpatient visits, and days lost from work as a result of TB infection.

€500 million every year represents an enormous cost, particularly considering that these costs are weighted towards countries that have smaller health budgets and smaller economies than the likes of Germany, France and the UK. It also represents nearly the entirety of the estimated €560million cost of developing a new TB vaccine, suggesting that a vaccine, if developed would return enormous financial benefits in just its second year after a full deployment.

The report went on to calculate the productivity losses associated with TB. This is an immensely challenging task requiring researchers to use models that put a monetary value on a human life. These models are called DALYs (disability adjusted life years). DALYs as a result of TB infection are then multiplied by a ‘value’ of one year life lost which the EC measures at € 52,000.

The result of this complicated mathematics is the headline figure that the EU loses €5.3billion every year in productivity as a result of TB. It is an astonishingly large number and one that certainly should highlight the impact of the disease.

Among the numbers is a warning that these costs might just be at the low end of the scale. Drug resistant strains of TB are much more expensive to treat. Europe, and particularly Eastern Europe, has a significant problem with DR TB which is vastly more complex and expensive to treat. The drugs cost a lot more and are highly toxic, resulting in a treatment regimen that is long and arduous and can result in terrible and long-lasting side effects.

Of course, the problem with all of this is that you can’t really put an economic value on a life lost or on the impact of a deadly and debilitating disease like TB. It is both right and incredibly unfortunate that aid must always be proven to be “value for money” and that accordingly, we somehow need to calculate an economic cost for diseases like TB to make a case for action on the disease.

This report does exactly that. The numbers involved are large, statistically well-founded and make a compelling case for action. As someone who has to make the case for action on TB, these numbers are a welcome addition to the armoury.

But it’s still a shame that the case is deemed to be more compelling when the value of action at the highest level is judged in terms of the money TB costs rather than the misery it causes.

You can read the full report.