Financing and cost-effectiveness analysis of public-private partnerships: provision of tuberculosis treatment in South Africa

Table 4 Treatment outcome and cost-effectiveness (CE) for each model of treatment provision in 2001 US$*

Treatment outcome**	PWP model		PNP model		Purely public model
	Site 1	Site 2	Site 3	Site 4	Site 5	Site 6
	N = 95	N = 423	N = 355	N = 50	N = 85	N = 174
Successfully treated^†	83 (87%)	368 (87%)	283 (80%)	41 (82%)	76 (89%)	129 (74%)
Cured^††	79 (83%)	321 (76%)	231 (65%)	41 (82%)	74 (87%)	121 (69%)
Failed^‡	1 (1%)	4 (1%)	3 (1%)	1 (2%)	0	1 (1%)
Died^‡‡	11 (12%)	47 (12%)	13 (4%)	4 (8%)	1 (1%)	4 (2%)
Interrupted^§	-	-	56 (15%)	4 (8%)	8 (10%)	40 (23%)
CE from the provider perspective
Total cost of treating patient	654	744	251	253	507	568
Treatment success rate^§§	87	87	80	82	89	74
Cure rate^∥	83	76	65	82	87	69
Cost per new smear-positive patient successfully treated	752	855	314	308	570	767
Cost per new smear-positive patient cured	788	979	386	308	583	823
CE from the patient perspective
Total cost of treating patient	N.A.	N.A.	39	37	102	122
Treatment success rate			80	82	89	74
Cure rate			65	82	87	69
Cost per new smear-positive patient successfully treated			49	45	115	165
Cost per new smear-positive patient cured			60	45	117	177
CE from the societal perspective
Total cost of treating patient^{∥ ∥}	654	744	290	290	609	690
Treatment success rate	87	87	80	82	89	74
Cure rate	83	76	65	82	87	69
Cost per new smear-positive patient successfully treated	752	855	362	354	684	932
Cost per new smear-positive patient cured	788	979	446	354	700	1 000

* Cost data from 2001. Average exchange rate prevailing in 2001 US$1 = R8.57.
** Source: Reports submitted to the provincial TB programmes.
^† The sum of those patients who were cured plus those who completed treatment but without laboratory proof of cure.
^†† Patients who were smear negative at the end of treatment.
^‡ Patients who remained or become again smear-positive at 5 months or later during treatment. Patients who were 'transferred out' are not included in the denominator (to be in line with international and national reporting requirements, this category of TB patients will in future be included in the denominator of the reporting district where they were initially registered). The number of patients who were 'transferred out': 1 (site 1), 4 (site 2), 31 (site 3), 9 (site 4), 16 (site 5) and 35 (site 6).
^‡‡ Patients who died for any reason during the course of TB treatment.
^§ Patients whose treatment was interrupted for 2 months or more.
^§§ Estimated as a ratio between the number of new smear-positive patients registered and the number of new smear-positive patients successfully treated.
^∥ Estimated as a ratio between the number of new smear-positive patients registered and the number of new smear-positive patients cured.
^{∥ ∥}This represents a sum of provider and patient costs for each site.

ISSN: 1478-7547