Cost-utility analysis of tuberculosis patients with directly observed treatment and self-administered treatment in an army hospital, Indonesia

Tuberculosis recorded as the 9^th cause of death worldwide and Indonesia becomes the 2^nd country with the highest tuberculosis incidence in the world. The previous study showed that tuberculosis can affect the patients' quality of life and high level of expenditures, so a study is needed to link both of them. In this study, a cost-utility analysis was conducted to see how the DOT (Directly Observed Treatment) and SAT (Self-Administered Treatment) influence the patient's quality of life and how much cost for each method. This study used a cross-sectional design with primary data and secondary data collection. The subjects were tuberculosis category I patients aged 18 years and over at Gatot Soebroto Army Hospital. Utilities were obtained with the help of the EQ-5D-5L questionnaire and the costs used were viewed from a social perspective with the components of direct medical costs, direct non-medical costs, and indirect costs. The results obtained in this study was the utility value of 0.718 with total expenses 5.499.656,00 IDR in the DOT group (n=12) and the utility value of 0.912 with the total expenses 5.804.887,00 IDR in the SAT group (n=30). Based on these values, the average cost-utility ratio in the DOT group was 7.659.688,02 IDR, in the SAT group was 6.365.007,67 IDR, and an incremental cost-utility ratio was 1.573.355,67 IDR/utility. The results showed that both methods can be selected according to the available resources, especially funds.