Shorter, six-month, all-oral treatment regimens for multidrug-resistant and rifampicin-resistant tuberculosis (MDR/RR-TB) are cost-effective and yield better health outcomes than longer regimens, according to an ICMR study. The study revealed that with the shorter regimen, the health system spends Rs 379 less per patient for each additional Quality Adjusted Life Year (QALY) gained compared to the standard regimen, indicating improved health outcomes at reduced costs. The research compared the cost-effectiveness of bedaquiline-based regimens—BPaL (bedaquiline, pretomanid, and linezolid) with the existing bedaquiline-containing shorter (9–11 months) and longer (18–20 months) treatment regimens used under the National TB Elimination Programme (NTEP).
The study also assessed BPaLM (with moxifloxacin) against the existing regimen and found it to be highly cost-effective, costing only Rs 37 more per patient per additional QALY gained compared to the standard regimen. Both regimens were linked to lower or comparable overall healthcare costs, encompassing medicines, hospital visits, and follow-up care. Multidrug-resistant and rifampicin-resistant tuberculosis (MDR/RR-TB) presents significant treatment challenges due to prolonged treatment duration, adverse effects, and higher costs.
Shorter all-oral regimens have the potential to enhance treatment adherence, reduce patient morbidity, facilitate quicker return to normal life, and lessen the burden on the health system, as per the findings. The study’s results offer crucial economic evidence supporting the use of shorter, all-oral regimens for managing MDR or RR-TB in India. By shortening treatment duration from 9–18 months or longer to six months, these regimens align with national priorities to optimize resource utilization and expedite progress towards TB elimination. Current treatment options for rifampicin-resistant tuberculosis (RR-TB) are limited, with available regimens often being lengthy and poorly tolerated.
Delhi’s Intermediate Reference Laboratory, Tuberculosis Centre, recently obtained its first certification from the Central Tuberculosis Division (CTD) to conduct Drug Susceptibility Testing (DST) for bedaquiline (BDQ) and Pretomanid (Pa), globally used for treating drug-resistant tuberculosis.
