Shorter All-Oral TB Treatments: A Cost-Effective Breakthrough for India, ICMR Study Reveals

Discover how shorter, all-oral treatments for drug-resistant TB are revolutionizing patient care and health economics in India, offering hope and efficiency.

New Regimens Emerge

A significant advancement in the fight against multidrug-resistant and rifampicin-resistant tuberculosis (MDR/RR-TB) has been identified by the ICMR–National

Institute for Research in Tuberculosis. This research indicates that employing six-month all-oral treatment regimens presents a more economical and health-beneficial alternative to the extended treatment durations currently practiced in India. The investigation, detailed in the Indian Journal of Medical Research, focused on bedaquiline-based therapies, specifically the BPaL (bedaquiline, pretomanid, and linezolid) and BPaLM (which includes moxifloxacin) regimens. These were benchmarked against the existing bedaquiline-inclusive shorter (9-11 months) and longer (18-20 months) treatment protocols established under the National TB Elimination Programme (NTEP). The findings strongly suggest a paradigm shift towards more efficient and effective TB management.

Economic & Health Gains

The comparative analysis conducted by the ICMR-NIRT revealed compelling economic and health advantages associated with the BPaL regimen. It was found to be not only more effective but also cost-saving. For every additional Quality Adjusted Life Year (QALY) achieved, the healthcare system actually expends ₹379 less per patient when compared to the conventional treatment approach. This demonstrates superior health outcomes coupled with reduced financial outlay. Similarly, the BPaLM regimen also proved highly cost-effective, requiring only an additional expense of ₹37 per patient for each extra QALY gained in comparison to the standard regimen. Crucially, both of these newer regimens were associated with overall healthcare costs that were either lower than or comparable to the existing treatments, encompassing expenses for medications, clinic visits, and ongoing follow-up care.

Patient & System Benefits

The challenges posed by MDR/RR-TB are substantial, largely due to the lengthy treatment periods, potential for adverse side effects, and the associated high costs. The advent of shorter, all-oral regimens promises to alleviate these burdens significantly. By reducing treatment duration to a mere six months, these regimens are projected to enhance patient adherence to therapy, thereby minimizing illness and expediting their return to normal daily life and productive activities. Furthermore, this efficiency translates into a decreased strain on the national health system, optimizing resource allocation. The study's conclusions offer robust economic evidence that strongly advocates for the adoption of these shorter, all-oral regimens for managing MDR/RR-TB across India, aligning perfectly with national objectives to improve resource utilization and accelerate the journey towards tuberculosis elimination.

Programmatic Adoption

The evidence emerging from this comprehensive study strongly supports the integration of shorter, all-oral treatment regimens into India's public health strategy for combating drug-resistant tuberculosis. The BPaL-based therapies, in particular, are positioned to be either cost-saving or highly cost-effective, making them an attractive option for widespread adoption within the National TB Elimination Programme (NTEP). Such a move would substantially bolster India's ongoing efforts to effectively manage and ultimately eradicate drug-resistant TB. By condensing treatment timelines from an extensive 9-18 months or longer down to a more manageable six months, these regimens not only offer a more humane and efficient patient experience but also contribute directly to the nation's strategic goals for optimizing resource management and achieving accelerated progress towards a TB-free India.