Student Dissertation

Agency : Economics of Non-Adherence; TB; Adherence Solutions

Objective : The aim is to study the economic effect of non-adherence on TB patients and the impact of tech solutions on medication medicine adherence.

Methodology : A comprehensive literature search was performed to study the impact of non-adherence on TB patients and costs related to it from research articles and the information provided by DOTS centers and private hospitals of Delhi. Study majorly focuses on the sputum positive TB patients who are non-adherent with the TB treatment course.

Findings : After the comprehensive study of the non-adherence in TB patients based on the literature review and data collected from the DOTS centers and private hospitals of Delhi, it showed that non-adherence to the treatment can cost around 590 times higher than the adherence cost to the patient.

Recommendations : Non-adherence may lead to the number of complications and conversion of TB to MDR-TB because of the resistance developed by the bacterial strain due to the discontinuation of dosage. Non-adherence may lead to an increased burden on a patient and an increased cost to the healthcare system in terms of increased length of stay increased no of dosages and increased the cost of medications. In this study, the cost of the treatment has been extracted under two heads: Direct cost and Indirect cost. Direct cost includes the medical and non-medical cost the indirect cost and Indirect cost includes the cost incurred in traveling, lodging, and food for the accompanying person. In the above findings, non-adherence has led to increased expenses and loss of wages due to illness, which could have been saved if the patient had been adherent to the prescribed regimen and had completed the required tenure of the treatment. To accomplish this, a solution- CAREDOSE will be provided to patients that will help them to be adherent to the treatment. They will receive pre-organized dose pouches with all relevant details around frequency, food directions, time and date of dose. Every time the dose will be due, they will receive a reminder on their phones to take the dose. According to WHO, more than 50% chronic patients are non-adherent to their medicine intake and close to 70% of these do not communicate this to their caregivers. Given non-adherence is a behavioral problem, CAREDOSE is tackling the problem with a behavioural solution, which will lead to a substantial decrease in the cost of the treatment as patients will now adhere to their prescribed medication.