Nagpur: Short-duration, all-oral treatment regimens used in India for drug-resistant tuberculosis (TB) are not only cost-effective but also deliver superior health outcomes compared to longer conventional therapies, according to an economic evaluation published in the Indian Journal of Medical Research.The study, conducted by the ICMR–National Institute for Research in Tuberculosis (ICMR-NIRT), examined two six-month, all-oral regimens — BPaL (bedaquiline, pretomanid and linezolid) and BPaLM (which additionally includes moxifloxacin).The findings demonstrate that these shorter regimens, currently deployed under the National Tuberculosis Elimination Programme (NTEP) for the treatment of multidrug-resistant and rifampicin-resistant TB (MDR/RR-TB), are both more affordable and clinically superior to the long-duration treatment protocols presently in use.The BPaL regimen emerged as more effective and cost-saving, with a reduction of ₹379 per patient for every additional quality-adjusted life year (QALY) gained compared to standard treatment, reflecting improved health outcomes at a lower overall cost to the healthcare system.The BPaLM regimen was also found to be highly cost-effective. Compared to standard therapy, it required only ₹37 in additional expenditure per patient for each extra QALY gained. Overall costs related to medicines, hospital visits, and follow-up care were either lower than or comparable to those under existing regimens.MDR/RR-TB poses significant treatment challenges due to prolonged therapy duration, adverse drug effects, and high costs. The introduction of short-course, all-oral regimens simplifies treatment, reduces patient morbidity, enables a quicker return to normal life, and eases the burden on the public health system.By cutting treatment duration from 9–18 months or longer to just six months, these regimens align with national priorities for efficient resource utilisation and accelerate progress towards India’s tuberculosis elimination goals, the study noted.The researchers concluded that BPaL-based regimens are either cost-saving or minimally cost-intensive and can be safely adopted under the NTEP to strengthen India’s response to drug-resistant TB.
