Table 2. Interventions included in the Belarus analysis.
| Intervention | Population(s) targeted | Description | Unit cost* (US$, 2015) | Spending (US$, 2015) |
|---|---|---|---|---|
| Screening and diagnosis interventions | ||||
| Active Case Finding | 15–64; 65+; PLHIV | Screening of high-risk groups that are considered at high risk of developing active TB (e.g. PLHIV, homeless, people who inject drugs etc.) with chest X-ray or fluorography | $1.00 | $942,159 |
| Incentivised Active Case Finding | 15–64; 65+; PLHIV | Active case finding with subsided transportation for healthcare workers and incentives for each case identified | $5.20 | Prospective intervention |
| Contact Tracing | All populations (contacts of people with active TB) | Tracing of household contacts of people diagnosed with active TB, and screening using symptomatic questionnaire, smear-sputum microscopy, and GeneXpert | $1.00 | $7,046 |
| Incentivised Contactì Tracing | All populations (contacts of people with active TB) | Contact tracing with subsided transportation for healthcare workers and incentives for each case identified | $5.20 | Prospective intervention |
| Symptomatic Diagnosis (including Xpert) | All populations | screen questions followed by smear-sputum microscopy, Gene Xpert and liquid culture for patients that present at a health facility with symptoms of TB | $39.98 | $770,489 |
| Mass-Screening | All populations | Yearly general population-wide mass-screening using chest X-rays and fluorography | $1.00 | $9,758,596 |
| Treatment for active TB | ||||
| Hospital Focused DS-TB | People receiving treatment for DS-TB | Treatment for DS-TB with hospitalisation for 60 days out of a total treatment duration of 180 days | $2,609.72 | $7,283,723 |
| Hospital Focused MDR-TB | People receiving treatment for MDR-TB | Standardised treatment regimen for multidrug-resistant TB (MDR-TB), with hospitalisation for 180 days out of a total treatment duration of 540 days | $14,158.05 | $12,884,772 |
| Hospital Focused XDR-TB | People receiving treatment for XDR-TB | Treatment for extensively drug-resistant TB (XDR-TB) with available second and third-line drugs, with hospitalisation for 240 days out of a total treatment duration of 660 days | $20,483.19 | $7,445,214 |
| Ambulatory DS-TB | People receiving treatment for DS-TB | WHO recommended outpatient service delivery, with hospitalisation only during the intensive phase of a given regimen or until smear conversion. Involves hospitalisation for 14 days out of a total treatment duration of 180 days | $1,877.83 | Prospective intervention |
| Ambulatory MDR-TB | People receiving treatment for MDR-TB | WHO recommended outpatient service delivery, with hospitalisation only during the intensive phase of a given regimen or until smear conversion. Standardised MDR-TB regimen with hospitalisation for 45 days out of a total treatment duration of 540 days | $10,196.29 | Prospective intervention |
| Ambulatory MDR-TB Short-Course | People receiving treatment for MDR-TB | Short-course MDR-TB regimen. Involves hospitalisation for 30 days, out of a total treatment duration of 315 days | $4,520.46 | Prospective intervention |
| Ambulatory XDR-TB | People receiving treatment for XDR-TB | WHO recommended outpatient service delivery, with hospitalisation only during the intensive phase of a given regimen or until smear conversion. Treatment for XDR-TB with available second and third-line drugs, with hospitalisation for 60 days out of a total treatment duration of 660 days | $15,440.95 | Prospective intervention |
| Incentivised Ambulatory DS-TB | People receiving treatment for DS-TB | Similar to the ambulatory DS-TB intervention, but incorporates financial incentives (food packages, outcome-based financing) based on the Mogilev District pilot project | $2,215.36 | Prospective intervention |
| Incentivised Ambulatory MDR-TB | People receiving treatment for MDR-TB | Similar to the ambulatory MDR-TB intervention, but incorporates financial incentives (food packages, outcome-based financing) based on the Mogilev District pilot project | $11,324.79 | Prospective intervention |
| Incentivised Ambulatory MDR-TB Short-Course | People receiving treatment for MDR-TB | Similar to the ambulatory MDR-TB short-course intervention, but incorporates financial incentives (food packages, outcome-based financing) based on the Mogilev District pilot project | $5,099.96 | Prospective intervention |
| Incentivised Ambulatory New Drugs MDR-TB | People receiving treatment for MDR-TB | Similar to the ambulatory MDR-TB intervention but with new and repurposed drugs, including bedaquiline and linezolid, added to the background regimen. Incorporates financial incentives (food packages, outcome-based financing) based on the Mogilev District pilot project | $14,797.00 | Prospective intervention |
| Incentivised Ambulatory XDR-TB | People receiving treatment for XDR-TB | Similar to the ambulatory XDR-TB intervention, but incorporates financial incentives (food packages, outcome-based financing) based on the Mogilev District pilot project | $16,782.95 | Prospective intervention |
| Incentivised Ambulatory New Drugs XDR-TB | People receiving treatment for XDR-TB | Similar to the ambulatory XDR-TB intervention but with new and repurposed drugs, including bedaquiline and linezolid, added to the background regimen. Incorporates financial incentives (food packages, outcome-based financing) based on the Mogilev District pilot project | $23,036.00 | Prospective intervention |
| Involuntary Isolation MDR-TB | People receiving treatment for MDR-TB | Treatment for people with MDR-TB with a history of adherence problems in a dedicated facility monitored by police | $45,588.00 | $10,895,532 |
| Involuntary Isolation XDR-TB | People receiving treatment for XDR-TB | Treatment for people with XDR-TB with a history of adherence problems in a dedicated facility monitored by police | $45,588.00 | $5,698,500 |
| Preventative interventions | ||||
| IPT for General Population | All populations (contacts of people with active TB) | Treatment of latent TB Infections with 6-months Isoniazid therapy in general population TB-contacts | $11.52 | $10,575 |
| IPT for PLHIV | PLHIV | Treatment of latent TB Infections with 6-months Isoniazid in PLHIV | $11.52 | $2,477 |
| BCG Vaccination | 0–4 years | Bacillus Calmette–Guérin (BCG) vaccination for newborns | $1.32 | $528,000 |
| Interventions or activities not included in the optimisation analysis (spending fixed) | ||||
| Solid Culture | People with MDR- or XDR-TB | Cost of solid culture testing to identify and confirm resistance types of MDR-TB and XDR-TB | $1.43 | $362,108 |
| Line Probe Assay | People with MDR- or XDR-TB | Cost of line probe assay (LPA) testing to identify and confirm resistance types of MDR-TB and XDR-TB | $16.16 | $78,938 |
| Tuberculin Skin Test | 0–4 years; PLHIV; contacts of people with active TB | Cost of conducting a tuberculin skin test (TST) test to diagnose latent TB infections | $4.32 | $475,200 |
| Palliative Care MDR/XDR | People receiving treatment for MDR- and XDR-TB | Palliative care for MDR-TB and XDR-TB patients with a history of non-adherence, repeated treatment failure, and adverse reactions | $5,108.00 | $2,894,426 |
| Alcohol Intervention | People receiving treatment for active TB with problems of alcohol abuse | Cost of alcohol programmes to support adherence to TB treatment regimens | n/a | $210,000 |
| Management (Including HR) | n/a | Administrative costs | n/a | $892,061 |
| Procurement Costs | n/a | As per TB sub-accounts of NHA | n/a | $649,349 |
| Other Costs | n/a | As per TB sub-accounts of NHA | n/a | $255,055 |
* Annualised treatment costs are used in the tool.
Note: All unit costs include the cost of service delivery in addition to medicine, test kits, etc. All treatment unit costs are per DS-TB, MDR-TB or XDR-TB case.