Shorter all-oral regimens for drug-resistant TB are cost-effective in India: ICMR study
New Delhi, February 12
An economic evaluation published in the Indian Journal of Medical Research has demonstrated that shorter, six-month all-oral treatment regimens for multidrug-resistant and rifampicin-resistant tuberculosis are cost-effective and offer improved health outcomes compared to the currently used longer regimens in India, the Ministry of Health and Family Welfare said.
According to a press release, the study was conducted by ICMR-National Institute for Research in Tuberculosis (ICMR-NIRT). It assessed the cost-effectiveness of bedaquiline-based regimens-BPaL (bedaquiline, pretomanid and linezolid) and BPaLM (with moxifloxacin)-in comparison with the existing bedaquiline-containing shorter (9-11 months) and longer (18-20 months) treatment regimens used under the National TB Elimination Programme (NTEP).
As per the release, the analysis revealed that the BPaL regimen is both more effective and cost-saving. For each additional Quality Adjusted Life Year (QALY) gained, the health system spends INR 379 less per patient compared to the standard regimen, indicating better health outcomes at lower costs.
The BPaLM regimen was also found to be highly cost-effective, with an additional expenditure of only INR 37 per patient per additional QALY gained compared to the standard regimen. Both regimens were associated with lower or comparable overall healthcare costs, including medications, hospital visits, and follow-up care, according to the release.
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.
The findings provide important economic evidence to support the use of shorter, all-oral regimens for MDR/RR-TB management in India. By reducing treatment duration from 9-18 months or longer to six months, these regimens align with national priorities to optimise resource utilisation and accelerate progress towards TB elimination.
The study concludes that BPaL-based regimens are likely to be cost-saving or highly cost-effective and may be considered for programmatic adoption under the NTEP to strengthen India's response to drug-resistant TB.
— ANI
Reader Comments
Excellent study. Saving ₹379 per patient per QALY might sound small, but at the national scale for NTEP, this adds up to massive savings. That money can be reinvested in diagnostics and awareness. Cost-effective healthcare is the need of the hour.
While the findings are promising, my respectful criticism is about implementation. Our primary health centres often struggle with drug supply chains. I hope the government ensures these new regimens are available consistently across all states, especially in rural areas.
As someone working in public health, the "faster return to normal life" point is crucial. Long treatments devastate family incomes. A 6-month regimen means patients can resume work sooner, reducing the economic shock of TB. This is holistic progress.
This aligns perfectly with the TB elimination goal. Shorter duration = better completion rates. Hope the NTEP adopts this swiftly. We need to move at mission mode to beat this disease. Jai Hind!
More effective AND cost-saving? That's a rare and wonderful combination in healthcare. This is the kind of evidence-based policy making we need. It will reduce the burden on families and the system. A very positive step.
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