Value of antimicrobials in the prevention and treatment of tuberculosis in the United States.
OBJECTIVE
To estimate the economic value of antimicrobials for the prevention and treatment of tuberculosis in the United States from 1954 through 1997.


METHODS
Published sources were used to estimate the burden of illness (direct medical costs, reductions in quality of life, and years of life lost) from active tuberculosis (TB) cases diagnosed between 1954 and 1997. Published literature concerning the pre-antimicrobial incidence rate and treatment of TB were extrapolated to estimate the burden of illness that would have occurred in the absence of antimicrobials.


RESULTS
Between 1954 and 1997, the use of antimicrobials reduced the number of newly diagnosed cases of active TB by 32% (relative to the number that would have occurred in the absence of antimicrobials), the number of mortalities by 81%, the number of life-years lost by 87%, and the cost of medical treatment by 76%. The total financial burden of illness over this time period (including the value of lost life-years) was reduced from $894 billion (in 1997 dollars) to $128 billion.


CONCLUSIONS
TB antimicrobials had a substantial health impact in the US from 1954 to 1997. This quantitative assessment of the economic impact of innovative biopharmaceutical products demonstrates the importance of continuing medical innovation.
Javitz
H S
HS
SRI International, Center for Health Sciences, Menlo Park, California 94025, USA. harold.javitz@sri.com
Ward
M
M
D000904:Antibiotics, Antitubercular / Q000191:economics* / Q000627:therapeutic use; D017046:Cost Savings; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D006801:Humans; D015994:Incidence; D011788:Quality of Life; D013997:Time Factors; D014376:Tuberculosis / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control*; D014481:United States
D000904:Antibiotics, Antitubercular