Medical Costs of Nontuberculous Mycobacterial Pulmonary Disease, South Korea, 2015-2019

Abstract

Nontuberculous mycobacterial pulmonary disease (NTM-PD) prevalence is a rising public health concern. We assessed the long-term healthcare systems perspective of costs incurred by 147 NTM-PD patients at a tertiary hospital in South Korea. Median cumulative total medical cost in managing NTM-PD patients was US $5,044 (interquartile range US $3,586-$9,680) over 49.7 months (interquartile range 33.0-68.2 months) of follow-up. The major cost drivers were diagnostic testing and medication, accounting for 59.6% of total costs. Higher costs were associated with hospitalization for Mycobacterium abscessus infection and pulmonary comorbidities. Of the total medical care costs, 50.2% were patient co-payments resulting from limited national health insurance coverage. As South Korea faces significant problems of poverty during old age and increasing NTM-PD prevalence, the financial and socio-economic burden of NTM-PD may become a major public health concern that should be considered with regard to adequate strategies for NTM-PD patients.

Keywords: Nontuberculous mycobacteria; South Korea; bacteria; cost of illness; health expenditures; healthcare costs; pulmonary disease; tuberculosis and other mycobacteria.

Figure 1

Patient selection for study of medical costs of nontuberculous mycobacterial pulmonary disease, South Korea, 2015–2019. NTM, nontuberculous mycobacteria; PD, pulmonary disease.

Figure 2

Diagnostic and treatment timeline for study of medical costs of nontuberculous mycobacterial pulmonary disease, South Korea, 2015–2019. The index date was defined as the date of the first pulmonology visit in which the physician initially evaluated the patient for NTM-PD. NTM, nontuberculous mycobacteria; PD, pulmonary disease.

Figure 3

Cost proportion analysis by follow-up period, in study of medical costs of nontuberculous mycobacterial pulmonary disease, South Korea, 2015–2019. Cumulative cost was analyzed by each follow-up period. Numbers within bars represent the percentage of each cost category.