ICMR Study Finds Six-Month All-Oral Regimens Cost-Effective for Drug-Resistant TB in India
An economic evaluation has found that shorter, six-month all-oral regimens for drug-resistant tuberculosis could deliver better outcomes at lower or comparable costs for India’s health system.
New Delhi: An economic evaluation has found that shorter, six-month all-oral regimens for drug-resistant tuberculosis could deliver better outcomes at lower or comparable costs for India’s health system. The findings, published in the Indian Journal of Medical Research, come from researchers at the ICMR–National Institute for Research in Tuberculosis (ICMR-NIRT). The study examined bedaquiline-based combinations, notably BPaL (bedaquiline, pretomanid, linezolid) and BPaLM (adding moxifloxacin), and compared them with the bedaquiline-containing regimens currently used under the National TB Elimination Programme (NTEP), which typically last between 9–11 months or 18–20 months. Researchers reported that the BPaL regimen was not only more effective but also cost-saving. The analysis indicated a reduction in overall spending per patient alongside gains in Quality Adjusted Life Years (QALYs), a standard measure combining survival and quality of life. The BPaLM regimen also demonstrated strong value, delivering additional health benefits with only a marginal rise in cost per QALY. Multidrug-resistant and rifampicin-resistant TB (MDR/RR-TB) remains a major public health challenge, largely due to lengthy treatments, side effects, and financial burden. Shorter, fully oral therapies could improve adherence, lessen patient hardship, and reduce demands on healthcare services. The authors conclude that BPaL-based regimens are likely to be cost-effective — and in some cases cost-saving — supporting consideration for wider programmatic use within India’s TB control strategy.