6 month oral TB regimens cost effective in India

Shorter, six month and all oral treatment regimens for multidrug resistant and rifampicin resistant tuberculosis (MDR/RR TB) are cost effective and deliver better health outcomes than longer regimens, an ICMR study said on Thursday.

With shorter regimen, "for each additional Quality Adjusted Life Year (QALY) gained, the health system spends Rs 379 less per patient compared to the standard regimen, indicating better health outcomes at lower costs,” said the study, according to a Ministry of Health and Family Welfare statement.

The study compared 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).

It also compared BPaLM (with moxifloxacin) with existing regimen and found the former highly cost effective, costing only Rs 37 more per patient per additional QALY gained compared with the standard regimen.

Both regimens were associated with lower or comparable overall healthcare costs, including medicines, hospital visits, and follow-up care. Multidrug resistant and rifampicin resistant tuberculosis (MDR/RR TB) poses significant treatment challenges due to prolonged treatment duration, adverse effects, and higher costs.

Shorter all-oral regimens can improve treatment adherence, reduce patient morbidity, and enable faster return to normal life, while also lowering the burden on the health system, said the findings.