To address the barriers in Tuberculosis diagnosis, treatment, and access to health systems, an innovative new drone technology is being piloted by Stony Brook University of New York, the Madagascar Ministry of Health, and the Institut Pasteur de Madagascar, with the aim of reaching the unreachable in remote Madagascar. This approach is called Drone Observed Therapy (DrOTs). Poor infrastructure, limited health care system with a majority of the population living in remote settings in developing countries with constrained resources justify the need of such an intervention to help provide treatment. My research proposes a cost-effectiveness analysis (CEA) of DrOTs in Madagascar, nested within the ongoing study described above. Comparing the costs and treatment completion rates of the intervention versus the standard of care for the treatment of drug sensitive TB is the central theme of my study. The results can be used to inform the design of future studies in order to determine if this technology can improve indicators of health system performance, and if a sound case can be made for integrating drones into the delivery supply chain.