An economic evaluation was made of the WHO tuberculosis control strategy in Armenia. The
evaluation concentrated on newly detected smear-positive patients. This strategy, characterized
by rapid case detection, mandatory hospitalization during the intensive phase of treatment and
shortened treatment duration, was compared with the strategy formerly employed, characterized
by extensive hospitalization and lengthy treatment. Data on diagnostic and treatment procedures
regarding TB patients, as well as costs of diagnostic procedures, drug regimens, hospital days
and outpatient visits, were gathered and compared with official guidelines for TB treatment. The
strategy implemented according to WHO guidelines (referred to hereafter as ‘the WHO
strategy’) turned out to be more cost-effective than the strategy formerly employed for TB
control in Armenia (referred to hereafter as ‘the old strategy’), with medical costs amounting to
$176 and $280 respectively per cured patient. This is mainly due to the shortened treatment
period and shorter length of hospitalization, although hospitalization rates are much higher in the
WHO strategy, combined with higher cure rates (72% on average compared with 65% in the old
strategy). Even when relatively favourable figures were assumed for the old strategy, the WHO
strategy was slightly more cost-effective. The use of diagnostic procedures and related costs in
patient follow-up were difficult to measure empirically in both strategies. Data from several TB
dispensaries and the main TB hospital indicate a decreasing use of smears and X-rays per patient
since the introduction of the WHO strategy. A more efficient use of diagnostic procedures in the
WHO strategy is likely, but could not be proven by empirical data. The main outcome of the
evaluation, therefore, might be conservative rather than progressive.