Abstract 21: Telemedicine And The Barbershop Model Of Hypertension Care For Black Men

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Ciantel A Blyler ◽  
Mohamad Rashid ◽  
Norma B Moy ◽  
Kayslee A Kemp ◽  
Florian Rader
Keyword(s):  
Blood Pressure ◽  
Los Angeles ◽  
Black Men ◽  
Medication Management ◽  
Cost Effective ◽  
Serious Adverse Events ◽  
Blood Pressure Study ◽  
Collaborative Practice Agreement ◽  
The Cost

Background: The Los Angeles Barbershop Blood Pressure Study (LABBPS) demonstrated both efficacy and sustainability of a new model of hypertension (HTN) care for non-Hispanic black men that links health promotion by barbers to medication management by specialty-trained pharmacists. Barriers to scaling the model include logistical inefficiencies that contribute to the cost of the intervention. Most notable was the amount of time pharmacists spent traveling between barbershops. To address this, we tested whether telemedicine (remote follow-up) could be substituted for in-person visits after blood pressure (BP) control was achieved. Methods: We enrolled 10 black male patrons with systolic BP ≥ 140 mm Hg in this proof-of-concept study in which barbers promoted follow-up with pharmacists who initially met each patron in the barbershop where they prescribed BP medication under a collaborative practice agreement with the patrons’ physician. Medications were titrated during bimonthly in-person visits to achieve a BP goal of ≤130/80 mmHg. Once BP goal was reached, monthly visits were done by videoconference while barbers assisted with BP checks. Final BP and safety outcomes were assessed at 12 months. Results: After exclusion of one participant who declined adherence, 9 patients completed the intervention. Baseline BP of 155 + 14 / 83 + 11 mmHg decreased by 29 + 13 / 8.9 + 15 mmHg (p<.0001), with eight participants (89%) achieving systolic control and seven (78%) diastolic control at 12 months. These new data are statistically indistinguishable from our previous LABBPS data (p=0.8 for both change in systolic BP and diastolic BP). Overall HTN control (≤ 130/80) was 67% (6 of 9), numerically greater than the 63% observed in LABBPS (p=N.S.). As intended, the mean number of in-person pharmacist visits per patron fell from 11 in LABBPS to 6.6 visits over 12 months. No treatment-related serious adverse events occurred. Cohort retention was 90%. Conclusions: Telemedicine represents a viable substitute for in-person visits, both improving pharmacist efficiency and reducing cost while preserving intervention potency. These findings are crucial for future broad-scale implementation efforts and development of cost-effective barbershop HTN management programs for black men.

scholarly journals Improving Efficiency of the Barbershop Model of Hypertension Care for Black Men With Virtual Visits

2021 ◽  
Author(s):  
Ciantel A. Blyler ◽  
Joseph Ebinger ◽  
Mohamad Rashid ◽  
Norma P. Moy ◽  
Susan Cheng ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Los Angeles ◽  
Black Men ◽  
Medication Management ◽  
Unique Identifier ◽  
Serious Adverse Events ◽  
Blood Pressure Study ◽  
Collaborative Practice Agreement ◽  
Virtual Visits ◽  
The Cost

Background The LABBPS (Los Angeles Barbershop Blood Pressure Study) developed a new model of hypertension care for non‐Hispanic Black men that links health promotion by barbers to medication management by pharmacists. Barriers to scaling the model include inefficiencies that contribute to the cost of the intervention, most notably, pharmacist travel time. To address this, we tested whether virtual visits could be substituted for in‐person visits after blood pressure (BP) control was achieved. Methods and Results We enrolled 10 Black male patrons with systolic BP ≥140 mm Hg into a proof‐of‐concept study in which barbers promoted follow‐up with pharmacists who initially met each patron in the barbershop, where they prescribed BP medication under a collaborative practice agreement with the patrons' physician. Medications were titrated during bimonthly in‐person visits to achieve a BP goal of ≤130/80 mm Hg. Once BP goal was reached, visits were done by videoconference. Final BP and safety outcomes were assessed at 12 months. Nine patients completed the intervention. Baseline BP of 155±14/83.9±11 mm Hg decreased by −28.7±13/−8.9±15 mm Hg ( P <0.0001). These data are statistically indistinguishable from prior LABBPS data ( P =0.8 for change in systolic BP and diastolic BP). Hypertension control (≤130/80 mm Hg) was 67% (6 of 9), numerically greater than the 63% observed in LABBPS ( P =not significant). As intended, the mean number of in‐person visits decreased from 11 in LABBPS to 6.6 visits over 12 months. No treatment‐related serious adverse events occurred. Conclusions Virtual visits represent a viable substitute for in‐person visits, both improving pharmacist efficiency and reducing cost while preserving intervention potency. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT 03726710.

scholarly journals Cost-effectiveness of Hypertension Treatment by Pharmacists in Black Barbershops

Circulation ◽  
2021 ◽  
Author(s):  
Kelsey B. Bryant ◽  
Andrew E. Moran ◽  
Dhruv S. Kazi ◽  
Yiyi Zhang ◽  
Joanne Penko ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Cost Effectiveness ◽  
Los Angeles ◽  
Black Men ◽  
Blood Pressure Control ◽  
Healthcare Costs ◽  
Cost Effective ◽  
Pressure Control ◽  
Healthcare Sector

Background: In the Los Angeles Barbershop Blood Pressure Study (LABBPS), pharmacist-led hypertension care in Los Angeles County Black-owned barbershops significantly improved blood pressure control in non-Hispanic Black men with uncontrolled hypertension at baseline. In this analysis, 10-year health outcomes and healthcare costs of one year of the LABBPS intervention versus control are projected. Methods: A discrete event simulation of hypertension care processes projected blood pressure, medication-related adverse events, fatal and non-fatal cardiovascular disease events, and non-cardiovascular disease death in LABBPS participants. Program costs, total direct healthcare costs (2019 USD), and quality-adjusted life years (QALYs) were estimated for the LABBPS intervention and control arms from a healthcare sector perspective over a 10-year horizon. Future costs and QALYs were discounted 3% annually. High and intermediate cost-effectiveness thresholds were defined as <$50,000 and <$150,000 per QALY gained, respectively. Results: At 10 years, the intervention was projected to cost an average of $2,356 (95% uncertainty interval [UI] -$264-$4,611) more per participant than the control arm and gain 0.06 (95% UI 0.01-0.10) QALYs. The LABBPS intervention was highly cost-effective, with a mean cost of $42,717 per QALY gained (58% probability of being highly and 96% of being at least intermediately cost-effective). Exclusive use of generic drugs improved the cost-effectiveness to $17,162 per QALY gained. The LABBPS intervention would be only intermediately cost effective if pharmacists were less likely to intensify antihypertensive medications when systolic blood pressure was ≥150 mmHg or if pharmacist weekly time driving to barbershops increased. Conclusions: Hypertension care delivered by clinical pharmacists in Black barbershops is a highly cost-effective way to improve blood pressure control in Black men.

Is Acupuncture for Pain Relief in General Practice Cost-Effective?

1999 ◽  
Vol 17 (2) ◽  
pp. 97-100 ◽  
Author(s):  
Steven Lindall
Keyword(s):  
General Practice ◽  
Pain Relief ◽  
Acupuncture Treatment ◽  
Cost Effective ◽  
Total Saving ◽  
Hospital Outpatient ◽  
The Cost ◽  
Lost To Follow Up ◽  
Practice Cost

Sixty-five selected patients with pain, mainly of musculo-skeletal origin, were offered treatment by a qualified medical acupuncturist in his general practice surgery as an alternative to hospital outpatient referral. The patients assessed their own outcomes on a digital scale: there were 46 successful treatments and 14 failures, with 5 being lost to follow up. The cost of acupuncture treatment was compared to that of the referral that would have been made if acupuncture had not been offered. The acupuncture was found to have cost £10,943 against a minimum likely cost for hospital referrals of £26,783. A minimum total saving for all 60 patients of £13,916 was determined, giving an average saving per patient of £232. Additional hidden savings through avoiding further hospital procedures and expenditure on medication were not taken into account. It is concluded that acupuncture in selected patients and when used by an appropriately qualified practitioner appears to be a cost-effective therapy for use in general practice, reducing the need for more expensive hospital referrals.

Abstract 53: Results Of The Nashville Barber-pharmacist Hypertension Management Pilot Study

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Jarod Parrish ◽  
Ciantel A Blyler ◽  
Henry E Okafor ◽  
L. Cindy Chang ◽  
Devika Nair ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pilot Study ◽  
Los Angeles ◽  
Care Delivery ◽  
Medication Management ◽  
Lessons Learned ◽  
Future Research ◽  
Hypertension Management ◽  
Male Clients ◽  
Community Stakeholders

Background: The Los Angeles Barbershop Blood Pressure Study (LABBPS) demonstrated that collaboration between barbers and pharmacists delivering hypertension management could significantly improve blood pressure as well as access to care. It is unknown if this model can be translated to other locations. This single-arm, proof-of-concept pilot study tested the development and implementation of a similar protocol in Nashville, TN (NCT04232124). Methods: Between 2019 and 2021, community stakeholders, clinicians, investigators, and the LABBPS team convened to adapt the study design and protocol. Established barbershops with barbers willing to be trained on study procedures were recruited as study sites. Non-Hispanic Black male clients, aged 35-79 years with systolic blood pressure (SBP) > 140 mmHg on two screening days were eligible for participation. Enrolled participants met with a pharmacist for lifestyle and medication management at least once monthly for a six-month period. Barbers measured blood pressure during haircuts for additional monitoring. Results: Eight barbershops in business for an average of 20 (± 5) years participated in the trial. Barbers from each shop (range: 1-4) were trained. A total of 419 clients completed screening visit 1, 82 were eligible and 52 (12%) completed visit 2. We enrolled 36, with 30 completing the initial clinical visit and 27 had complete data at 6-months. Participants were on average age 50 (± 10) years, had a body mass index 33 (± 6), 44% were currently smoking, 52% with high school or less education, and 56% reported current primary care. Baseline BP 157.7±17.1/ 95.1±13.9 mmHg improved to 125.7±11.9/75.6±9.5, a change of -32.1±21.6/ -19.5±14.1, respectively. At 6-months 85% of the group had a BP<140/90, 74% BP<135/85, and 67% BP<130/80. At baseline 15% of participants reported health as excellent/very good and this increased to 56% at 6-months (p=0.002). Adverse reactions reported were minimal. Conclusion: Implementation of the barber-pharmacist model of hypertension management and care delivery improved BP control among hypertensive Black men in Nashville. Lessons learned regarding adaptation overcoming unforeseen barriers will inform expansion into additional naïve locations for future research.

Cost-effectiveness of zoledronic (ZOL) acid plus endocrine therapy (ET) in premenopausal women with early breast cancer (EBC) from a Canadian perspective

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 557-557
Author(s):  
K. E. Ougari ◽  
C. Taneja ◽  
O. Sofrygin ◽  
S. Kaura ◽  
T. Delea
Keyword(s):  
Breast Cancer ◽  
Cost Effectiveness ◽  
Premenopausal Women ◽  
Cost Effective ◽  
System Perspective ◽  
Healthcare System Perspective ◽  
The Cost ◽  
Canadian Healthcare System ◽  
Canadian Healthcare

557 Background: The Austrian Breast and Colorectal Cancer Study Group Trial 12 (ABCSG-12) examined the efficacy of 3 years (yrs) of treatment with goserelin in combination with ET (anastrozole or tamoxifen) with or without ZOL 4 mg q6 mos in 1,803 premenopausal women with EBC (median age 45 yrs). After a median follow-up of 47.8 mos (max 84 mos), risk of disease-free survival (DFS) events was reduced by 36% (HR = 0.64; p = 0.01) in patients (pts) who received ZOL (ZOL+ET) compared with those who did not (ET). Methods: A Markov model was used to estimate the cost per quality adjusted life years (QALYs) gained of 3 years treatment duration of ZOL+ET versus ET-only in premenopausal women with EBC based on results of the ABCSG-12. A Canadian healthcare system perspective and a lifetime timeframe were used. Outcomes and cost of breast cancer recurrence were based on recent published studies. Results were generated under 2 scenarios regarding duration of benefit (reduction in risk of recurrence) with ZOL: (1) Benefits persist to maximum follow-up in ABCSG-12 (trial benefit); (2) Benefits persist until death (lifetime benefit). Results: The cost of 3 years of ZOL (medication and administration) is 4 191 $CDN. Under the lifetime benefit scenario, 73% of these costs are offset by savings in the cost of recurrences. Under the trial benefit scenario, 12% are offset. QALYs gained are 1.63 yrs and 0.52 yrs under the lifetime and trial benefit scenarios respectively; cost-effectiveness is 1 122 $CDN and 3 675 $CDN per QALY gained respectively, which is well below the 50 000 $CDN per QALY threshold frequently used to assess whether therapies are cost-effective. Conclusions: The combination of ZOL + ET is a cost-effective use of healthcare resources from a Canadian healthcare system perspective. [Table: see text]

scholarly journals Cost-effectiveness of Memory Assessment Services for the diagnosis and early support of patients with dementia in England

2017 ◽  
Vol 22 (4) ◽  
pp. 226-235 ◽  
Author(s):  
Manuel Gomes ◽  
Mark Pennington ◽  
Raphael Wittenberg ◽  
Martin Knapp ◽  
Nick Black ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Effective ◽  
Base Case ◽  
Memory Assessment ◽  
Life Years ◽  
Follow Up Care ◽  
Related Quality ◽  
Mean Differences ◽  
The Cost

Background Policy makers in England advocate referral of patients with suspected dementia to Memory Assessment Services (MAS), but it is unclear how any improvement in patients’ health-related quality of life (HRQL) compares with the associated costs. Aims To evaluate the cost-effectiveness of MAS for the diagnosis and follow-up care of patients with suspected dementia. Method We analysed observational data from 1318 patients referred to 69 MAS, and their lay carers (n = 944), who completed resource use and HRQL questionnaires at baseline, three and six months. We reported mean differences in HRQL (disease-specific DEMQOL and generic EQ-5D-3L), quality-adjusted life years (QALYs) and costs between baseline and six months after referral to MAS. We also assessed the cost-effectiveness of MAS across different patient subgroups and clinic characteristics. Results Referral to MAS was associated with gains in DEMQOL (mean gain: 3.48, 95% confidence interval: 2.84 to 4.12), EQ-5D-3L (0.023, 0.008 to 0.038) and QALYs (0.006, 0.002 to 0.01). Mean total cost over six months, assuming a societal perspective, was £1899 (£1277 to £2539). This yielded a negative incremental net monetary benefit of −£1724 (−£2388 to −£1085), assuming NICE’s recommended willingness-to-pay threshold (£30,000 per QALY). These base case results were relatively robust to alternative assumptions about costs and HRQL. There was some evidence that patients aged 80 or older benefitted more from referral to MAS (p < 0.01 from adjusted mean differences in net benefits) compared to younger patients. MAS with over 75 new patients a month or cost per patient less than £2500 over six months were relatively more cost-effective (p < 0.01) than MAS with fewer new monthly patients or higher cost per patient. Conclusions Diagnosis, treatment and follow-up care provided by MAS to patients with suspected dementia appears to be effective, but not cost-effective, in the six months after diagnosis. Longer term evidence is required before drawing conclusions about the cost-effectiveness of MAS.

scholarly journals Cost Effectiveness Analysis of Candesartan Therapy in Comparison to Candesartan-Amlodipine Therapy on Hypertensive Outpatients

2019 ◽  
Vol 7 (22) ◽  
pp. 3837-3840
Author(s):  
Faridah Baroroh ◽  
Andriana Sari ◽  
Noviana Masruroh
Keyword(s):  
Blood Pressure ◽  
Cost Effectiveness ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Effectiveness Analysis ◽  
Significant Difference ◽  
Hypertension Therapy ◽  
The Mean ◽  
The Cost

BACKGROUND: he achievement of optimal hypertension therapy requires cost-effective medicine. The treatment of hypertensive patients needs for long-term medication have made medical costs a prime issue in health economics. AIM: This study aims to determine the cost effectiveness of candesartan therapy compared to candesartan-amlodipine therapy on hypertensive outpatients. METHODS: This is a prospective cohort study that compares candesartan therapy to candesartan-amlodipine therapy at a public hospital from payers’ perspective. The outcome is the percentage of targeted blood pressure decrease after three months of therapy. The cost effectiveness analysis uses the Incremental Cost Effectiveness Ratio (ICER) based on the ratio of cost difference to the outcome in both therapy groups. RESULTS: As many as 111 patients participated in this research, comprising 40 candesartan therapy patients and 71 patients with the combination of candesartan-amlodipine. Of the participants, 63.96% were female, 57.66% were aged 60 or older, and 56.32% had diabetes mellitus as the most common complication. Results show that the average direct medical cost per patient for a therapy of three months with candesartan was IDR 1,050,536 ± 730,007 and IDR 760,040 ± 614,290 for a candesartan-amlodipine therapy. The mean decline of systolic and diastolic blood pressure under candesartan therapy is less than that of candesartan-amlodipine, although without any significant difference (p > 0.05). It follows that the effectiveness of candesartan (85%) is greater than that of the candesartan-amlodipine combination (84.50%). Candesartan therapy is thereby more cost-effective with an ICER value of IDR 580,993/%. CONCLUSION: Hypertension therapy by candesartan is more cost-effective than candesartan-amlodipine therapy with a cost addition of IDR 580,993.

scholarly journals Modeling the Cost-effectiveness of Esophageal Cancer Screening in China

2020 ◽  
Author(s):  
Yuanyuan LI ◽  
Lingbin Du ◽  
Youqing Wang ◽  
Yuxuan Gu ◽  
Xuemei Zhen ◽  
...  
Keyword(s):  
Sensitivity Analysis ◽  
Esophageal Cancer ◽  
Cost Effectiveness ◽  
Cancer Screening ◽  
Cost Effective ◽  
Endoscopic Screening ◽  
Lugol’S Iodine ◽  
Iodine Staining ◽  
The Cost

Abstract Background : This study aimed to examine the cost-effectiveness of standard endoscopic screening with Lugol’s iodine staining for EC (esophageal cancer) screening in China. Methods : A Markov decision analysis model with eleven states was built. Individuals aged 40 to 69 years were classified into six age groups according to five-year intervals. Three different strategies were adopted for each cohort: (1) no screening; (2) endoscopic screening with Lugol’s iodine staining with annual follow-up for low-grade intraepithelial neoplasia; and (3) endoscopic screening with Lugol’s iodine staining without follow-up. Quality-adjusted life-years (QALYs) indicated the effectiveness . The incremental cost-effectiveness ratio (ICER) was used as the evaluating indicator. Sensitivity analysis was performed to assess the robustness of the model. Results : Screening with follow-up was the undominated strategy, which saved USD 10942.57 and USD 6611.73 for individuals aged 40-44 and 45-49 years, respectively, per QALY gained. For those aged 50-69 years, the nonscreening scenarios were undominated. Screening without follow-up were extended dominated strategies. Compared to screening strategies without follow-up, all the follow-up strategies were found to be cost effective, with the ICER increasing from 299.57 USD/QALY for individuals 40-44 years to 1617.72 USD/QALY for individuals 65-69 years. Probabilistic sensitivity analysis supported the results of the base case analysis. Conclusions : EC screening with follow-up targeting individuals aged 40-49 years was the most cost-effective strategy.

scholarly journals Cost analysis of two follow-up strategies for localized kidney cancer: a Canadian cohort comparison

2013 ◽  
Vol 4 (5) ◽  
pp. 322
Author(s):  
Marie Dion ◽  
Carlos H. Martínez ◽  
Andrew K. Williams ◽  
Venu Chalasani ◽  
Linda Nott ◽  
...  
Keyword(s):  
Disease Free Survival ◽  
Cost Effective ◽  
Metastatic Renal Cancer ◽  
Free Survival ◽  
Primary Renal Cell Carcinoma ◽  
Survival Endpoints ◽  
The Cost ◽  
Theoretical Cost ◽  
Disease Free

Introduction: The cost of surveillance strategies in patients afterradical nephrectomy for localized primary renal cell carcinoma(RCC) has not been evaluated. We compared the costs of 2 differentsurveillance strategies, the new Canadian Urological Association(CUA) guidelines and the old strategy implemented in our institution. Methods: Seventy-five patients who underwent radical nephrectomyfor primary non-metastatic renal cancer were retrospectivelyreviewed. The direct cost of surveillance was determined and comparedwith the theoretical cost which would have been accruedusing the CUA guidelines. Results: Our mean follow-up was 31.1 (SD ± 20.4) months. Theoverall and disease-free survival endpoints were 87.7% and 85.2%,respectively. Total medical costs were higher for our old institutionalsurveillance strategy than the CUA guidelines ($181 861vs. $135 054). For the complete follow-up of 75 patients, a costsavingsof $46 806 could have been achieved following the CUAguidelines (p = 0.002). Of recurrences, 7 of 8 were detected by routinescreening, only 1 recurrence was identified by symptoms. Thecost per recurrence detected in our old protocol was $9 812.92.The increased cost of our institution was due to more visits withbasic testing, symptomatic investigation, and follow-up of imagingtests. The median percent cost attributable to these extra tests was15% (range 0 to 59). Conclusion: Based on our results, we endorse the new CUA surveillancestrategy in RCC follow-up as appropriate and cost effective incomparison with previous follow-up strategies used at our institution.Can Urol Assoc J 2010;4(5):322-326Introduction : Le coût associé aux stratégies de surveillance despatients ayant subi une néphrectomie radicale en raison d’un hypernéphromeprimitif localisé n’a jamais été évalué. Nous avons comparéles coûts de deux stratégies de surveillance différentes, soitles nouvelles lignes directrices de l’Association des urologues duCanada (AUC) et l’ancienne stratégie utilisée à notre établissement. Méthodologie : Soixante-quinze patients qui ont subi une néphrectomieradicale en raison d’un néphrome primitif non métastatiqueont été passés en revue de façon rétrospective. Les coûts directs dela surveillance ont été déterminés et comparés avec le coût théoriquequi aurait été comptabilisé en suivant les lignes directrices de l’AUC. Résultats : La durée moyenne du suivi était de 31,1 mois (ÉT ± 20,4).La survie globale et la survie sans maladie étaient de 87,7 % et 85,2%, respectivement. Les coûts médicaux totaux étaient plus élevés avecl’ancienne stratégie de surveillance de notre établissement par rapportaux lignes directrices de l’AUC (181 861 $ contre 135 054 $). Deséconomies de 46 806 $ auraient pu être réalisées en suivant leslignes directrices de l’AUC pour le suivi complet des 75 patients(p = 0,002). Quant aux récurrences, 7 sur 8 ont été décelées lorsde tests de routine, et une seule a été décelée par la présence desymptômes. Le coût d’une récurrence décelée selon notre ancienprotocole était de 9 812,92 $. Le coût plus élevé lié au protocole denotre établissement est attribuable à un nombre plus élevé de visitesavec épreuves de routine, vérification des symptômes et suivi desépreuves d’imagerie. Le pourcentage médian du coût attribuable àces épreuves supplémentaires était de 15 % (0 à 59 %). Conclusion : En fonction de nos résultats, nous appuyons la nouvellestratégie de surveillance de l’AUC pour le suivi des casd’hypernéphrome; cette stratégie nous semble approprié et rentableen comparaison avec les stratégies auparavant utilisées à notre

scholarly journals Cost-effectiveness of TB treatments to Burmese and Laotian patients by Thai hospitals on the border with Myanmar and Laos

2019 ◽  
Vol 34 (1) ◽  
pp. 13-21
Author(s):  
Onn Laingoen ◽  
Tawatchai Apidechkul ◽  
Panupong Upala ◽  
Ratipark Tamornpark ◽  
Chaleerat Foungnual ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Care Program ◽  
Cost Effective ◽  
Cost Effectiveness Ratio ◽  
Content Type ◽  
Total Cost ◽  
Tb Treatment ◽  
Retrospective Data Collection ◽  
The Cost

Purpose The purpose of this paper is to estimate the cost-effectiveness of tuberculosis (TB) treatment and care in two Thai hospitals located on the borders with Myanmar and Laos. Design/methodology/approach A retrospective data collection was conducted to analyze all costs relevant to TB treatment and care from Mae Sai and Chiang Sean Hospitals. The cost related to TB treatment and care and the number of successful TB treatment from January 1 to December 31, 2017 were used for the calculation. The cost-effectiveness ratio (C/E) and the incremental cost-effectiveness ratio (ICER) were the outcomes. Findings In 2017, the total cost of the TB treatment and care program at Mae Sai Hospital was 482,728.94 baht for 57 TB patients. The cast per treated case per year was 8,468.93 baht. The C/E was 10,971.11 baht per successful TB treatment (44 successful cases). The total cost of the TB treatment and care program at Chiang Sean Hospital was 330,578.73 baht for 39 TB patients. The cost per treated case per year was 8,476.38 baht. The C/E was 22,038.58 baht per successful TB treatment (15 successful cases). The ICER was 5,246.56 baht. The Mae Sai Hospital model was more cost-effective in terms of the treatment and care provided to Burmese patients with TB than the Chiang Sean Hospital model for Laotian patients with TB. Originality/value To improve the cost-effectiveness of TB treatment and care programs for foreign patients in hospitals located on the Thai border, focus should be placed on patient follow-up at the community or village level.

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