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Despite <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> diagnosis and care usually being offered for free, <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> patients can still face substantial costs, especially in the context of multi\u2010drug resistance (<jats:styled-content style=\"fixed-case\">MDR<\/jats:styled-content>). The End <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> Strategy calls for zero <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content>\u2010affected families incurring \u2018catastrophic\u2019 costs due to <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> by 2025. This paper examines, by <jats:styled-content style=\"fixed-case\">MDR<\/jats:styled-content> status, the level and composition of costs incurred by <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content>\u2010affected households during care seeking and treatment; assesses the affordability of <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> care using catastrophic and impoverishment measures; and describes coping strategies used by <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content>\u2010affected households to pay for <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A nationally representative survey of <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> patients at public health facilities across Ghana.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We enrolled 691 patients (66 <jats:styled-content style=\"fixed-case\">MDR<\/jats:styled-content>). The median expenditure for non\u2010<jats:styled-content style=\"fixed-case\">MDR TB<\/jats:styled-content> was <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content>$429.6 during treatment, <jats:italic>vs<\/jats:italic>. <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content>$659.0 for <jats:styled-content style=\"fixed-case\">MDR<\/jats:styled-content> patients (<jats:italic>P<\/jats:italic>\u2010value = 0.001). Catastrophic costs affected 64.1% of patients. <jats:styled-content style=\"fixed-case\">MDR<\/jats:styled-content> patients were pushed significantly further over the threshold for catastrophic payments than <jats:styled-content style=\"fixed-case\">DS<\/jats:styled-content> patients. Payments for <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> care led to a significant increase in the proportion of households in the study sample that live below the poverty line at the time of survey compared to pre\u2010<jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> diagnosis. Over half of patients undertook coping strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> patients in Ghana incur substantial costs, despite free diagnosis and treatment. High rates of catastrophic costs and coping strategies in both non\u2010<jats:styled-content style=\"fixed-case\">MDR<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">MDR<\/jats:styled-content> patients show that new policies are urgently needed to ensure <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> care is actually affordable for <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.13085","type":"journal-article","created":{"date-parts":[[2018,5,31]],"date-time":"2018-05-31T13:44:42Z","timestamp":1527774282000},"page":"870-878","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":58,"title":["How affordable is <scp>TB<\/scp> care? 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