Shorter Six-Month Oral Regimens For Drug-Resistant TB Prove Cost-Effective: ICMR Study

Shorter, six-month and all-oral treatment regimens for multidrug-resistant and rifampicin-resistant tuberculosis (MDR/RR-TB) are cost-effective and deliver improved health outcomes compared to longer therapies, an Indian Council of Medical Research (ICMR) study said on Thursday.

According to a Ministry of Health and Family Welfare statement, the study found, “With the shorter regimen, 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 research compared bedaquiline-based regimens, BPaL (bedaquiline, pretomanid, and linezolid), with the existing bedaquiline-containing shorter (9–11 months) and longer (18–20 months) treatment regimens implemented under the National TB Elimination Programme (NTEP).

It also evaluated BPaLM (with moxifloxacin) against the current standard regimen and found it to be highly cost-effective, costing only Rs 37 more per patient per additional QALY gained compared with the standard regimen.

Both BPaL and BPaLM regimens were associated with lower or comparable overall healthcare expenditure, including the costs of medicines, hospital visits and follow-up care.

MDR/RR-TB remains difficult to treat due to prolonged treatment durations, adverse effects and higher financial burden.

The findings indicate that shorter all-oral regimens can enhance adherence, reduce patient morbidity and enable a quicker return to normal life, while easing pressure on the healthcare system.

“The findings provide important economic evidence to support the use of shorter, all-oral regimens for MDR or RR-TB management in India. By reducing treatment duration from 9–18 months or longer to six months, these regimens align with national priorities to optimise resource utilisation and accelerate progress towards TB elimination,” the statement said.

Meanwhile, Delhi’s Intermediate Reference Laboratory, Tuberculosis Centre, has received certification from the Central Tuberculosis Division (CTD) to conduct Drug Susceptibility Testing (DST) for bedaquiline (BDQ) and Pretomanid (Pa), used globally for drug-resistant TB treatment.