The Iowa TB Control Program provides incentive funding to LPHAs to perform DOT for suspected/confirmed cases of TB disease. Clinical benefits of DOT include significant reductions in disease relapse, treatment failure, and development of multidrug-resistant TB (MDR-TB). A cost benefits analysis demonstrates it cost $2,500 to treat drug susceptible TB and $250,000 to treat MDR-TB.
There is limited availability for DOT incentive funding for LTBI with high-risk patients (HIV+ individuals, children less than 5 years of age, MDR/XDR-TB contacts).
It is the expectation that health departments that accept incentive funding for DOT will perform DOT with the patient until treatment completion. Regardless of availability of incentive funding, DOT remains the standard of care. The CDC, IDSA, WHO, and ATS recommend all healthcare providers implement DOT on each active case of TB.
While there is no incentive funding for extrapulmonary cases of TB disease, DOT is still strongly recommended for the same clinical reasons listed above.
Contact the TB Program Manager at 515-281-7504 to discuss DOT reimbursement.