TB Treatment Costing Medical Schemes R146 Million annually

Tuberculosis (TB) diagnosis and treatment cost South Africa’s second largest medical scheme administrator just under R146-million in 2009, with over 100 000 claims being registered in KwaZulu-Natal alone.

Gauteng showed the second highest incidence of the disease at close to 60 000 claims, with the Eastern and Western Cape third and fourth respectively, with under 20 000 claims.

According to research carried out by Metropolitan Health Group, the highest incidence of TB among medical scheme members is among the economically active age bands of 20 to 60 years of age.

“This group of people are most active in terms of contact with others and therefore show a higher incidence of the disease,” said Dr Safwaan Desai of Metropolitan Health Group. “Only 5% to 10% of individuals exposed develop TB, but it is still advisable for household members and people who have close regular contact with a person who has TB, such as friends, work colleagues and classmates, to be tested.”

Importantly, the development of TB depends on the immune status of the patient. The very young (with immature immune systems), the old (with poor immune response and general physical frailty) and those with weakened immune systems are more prone to developing the disease. The risk in people living with HIV/AIDS is thus very high. Some types of cancers and treatments for cancers may increase the likelihood of infection.

“Our figures in 2008 and 2009 show a greater number of women who are seeking treatment for this disease. This reflects the specific membership profile of our medical schemes and differs from the national statistics which show that up to 70% of those who develop the disease are male,” Dr Desai said.

TB remains one of the most devastating diseases in South Africa, both in economic terms and quality of life. It is a notifiable disease and is recognised by medical schemes as a condition for which Prescribed Minimum Benefits (PMB) will be paid.

With increased awareness and early access to treatment as well as rigid adherence to treatment schedules, much can be done to ensure that the burden of this disease is contained and the emergence of resistant forms of the disease can be minimised,” Dr Desai said.