ObjectivesA growing interest in healthcare costs and patients’ health-related quality of life (HRQoL) exists in the context of the increasing importance of health technology assessment (HTA) in countries with high numbers of the human immunodeficiency virus (HIV) and tuberculosis (TB) patient populations, such as Indonesia. This study aimed to analyse the HRQoL and out-of-pocket (OOP) costs of HIV-, TB-, and TB/HIV co-infected participants in a city in Indonesia with a high prevalence of HIV and TB. MethodsA cross-sectional survey was conducted in the voluntary counseling and testing (VCT) and lung clinics of Bekasi City Public Hospital (Indonesia) from January to March 2018. Patients’ HRQoL was measured using the EQ-5D 5L questionnaire, while OOP costs were extracted from a semi-structured questionnaire. ResultsOut of the 460 eligible participants, 82% resided in the city, 48% of them were married, and their median age was 34. Less than half were insured, and more than half had no source of income. The median values of health utilities for HIV, TB, and TB/HIV participants were perceived as potentially high (1.0, 0.9, and 0.8, respectively). The TB/HIV co-infected outpatients had the highest out-of-pocket costs ($94.5), with the largest contribution coming from direct medical OOP expenditures. Taking loans from family members was adopted as a financial strategy to overcome inadequate household incomes and high treatment costs. ConclusionThis study suggests that TB/HIV coinfection potentially lowers HRQoL, increases healthcare costs, and the need for economic analysis to underpin cost-effective treatment in such patients.