Abstract
PURPOSE: To use time-driven activity-based costing (TDABC) to evaluate costs associated with locally performing sclerotherapy for the treatment of venous malformations (VMs) in Tanzania in comparison to treatment abroad.
MATERIALS AND METHODS: A single-center retrospective cost-analysis was performed on 102 consecutive polidocanol foam sclerotherapy sessions on 53 patients from 9/2022-4/2024 for treatment of VMs in Tanzania. Using TDABC, process maps detailing the VM care cycle were developed into four stages: clinic, pre-intervention, intervention, and post-intervention. Time allocation of resources, including labor, was evaluated using survey data and input from involved medical and accounting staff.
RESULTS: The total TDABC cost of VM treatment was $538.61. Resource utilization accounted for 81.8% ($440.58) of the cost and labor 18.2% ($98.02). The clinic stage accounted for 4.0% ($21.30) of the cost, pre-intervention 53.8% ($289.85), intervention 33.9% ($182.64), and post-intervention 8.4% ($45.00). MRI utilization was overall the largest contributing cost: 36.6% ($197).
CONCLUSIONS: The calculated cost of VM treatment in Tanzania was 7.69 times less than the primary alternative treatment pathway, referral abroad (quoted at $4,140) - highlighting the potential cost-effectiveness of investing in local interventional radiology services to address patient needs in underserved settings. Such analysis is vital in resource-limited populations, where weighing costs and health benefits ensures the most efficient use of scarce healthcare resources.