New Delhi: An ICMR study has found that shorter all-oral TB regimens for multidrug-resistant and rifampicin-resistant tuberculosis are cost-effective and improve health outcomes in India.
The economic evaluation, published in the Indian Journal of Medical Research, compared six-month bedaquiline-based regimens with existing longer treatment options under the National TB Elimination Programme. ICMR–National Institute for Research in Tuberculosis conducted the study.
Researchers assessed BPaL (bedaquiline, pretomanid and linezolid) and BPaLM regimens against the current 9–11 month shorter and 18–20 month longer regimens. The analysis showed that the shorter all-oral TB regimens deliver better value for money.
The BPaL regimen proved both more effective and cost-saving. For each additional Quality Adjusted Life Year gained, the health system spent INR 379 less per patient compared to the standard regimen. Therefore, patients achieved better outcomes at lower cost.
The BPaLM regimen also showed strong economic value. It required only INR 37 more per patient per additional QALY gained than the standard regimen. However, overall healthcare costs, including medicines and follow-up visits, remained lower or comparable.
Economic gains from shorter all-oral TB regimens under NTEP
MDR/RR-TB treatment often involves long duration, adverse effects and high costs. Consequently, patients face treatment fatigue and higher morbidity. The shorter all-oral TB regimens reduce treatment duration to six months. As a result, they can improve adherence and enable faster return to normal life.
Moreover, shorter treatment lowers the burden on the public health system. It also supports efficient resource use under national TB control efforts. The study said these findings provide economic evidence for adopting six-month regimens in programme settings.
Researchers concluded that BPaL-based regimens are likely to be cost-saving or highly cost-effective. Therefore, authorities may consider programmatic adoption under NTEP to strengthen India’s response to drug-resistant TB.
