NEW DELHI: A 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 currently used in India, an ICMR study has said.
The economic evaluation conducted by ICMR's National Institute for Research in Tuberculosis (NIRT) also found that the new treatment can easily be adhered to by the patients, thus reducing the disease burden.
Published in the Indian Journal of Medical Research (IJMR), the study assessed the cost-effectiveness of the shorter bedaquiline-based regimens - BPaL (bedaquiline, pretomanid and linezolid) and BPaLM (with moxifloxacin)- in comparison with the nine-to-11-month and the 18-to 20-month-long bedaquiline-containing treatment plans used under the National TB Elimination Programme (NTEP).
The analysis revealed that the BPaL regimen is more effective against multidrug-resistant and rifampicin-resistant tuberculosis and, at the same time, more economical.
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.
The BPaLM regimen was also found to be highly cost-effective, with an additional expenditure of only Rs. 37 per patient per additional QALY gained compared to the standard regimen.
Both regimens were associated with lower or comparable overall healthcare costs, including medicines, hospital visits, and follow-up care.
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 nine–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.
India contributes about one-fourth of the world's tuberculosis (TB) burden, with around 2.5 million new cases and nearly 3,00,000 deaths annually.
India had aimed to eliminate TB by 2025, ahead of the global mandate of 2030.