The Open Public Health Journal


ISSN: 1874-9445 ― Volume 14, 2021

Cost-Effectiveness of Bedaquiline in Multidrug Resistant Tuberculosis: A Review

Evita Sari1, Neily Zakiyah1, 2, Prayudi Santoso3, Melisa I Barliana1, 4, *
1 Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Indonesia
2 Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia
3 Department of Internal Medicine, Faculty of Medicine, Universitas Padjajaran, Bandung, Indonesia
4 Department of Biological Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia

Abstract

Background:

Multidrug Resistant Tuberculosis (MDR-TB) remains a burden on the healthcare system and public health. Evidence on cost and cost-effectiveness on MDR-TB treatment option is necessary in order to provide evidence-based recommendation for policymakers. The main therapy for MDR-TB consists of a combination of at least five types of anti-tuberculosis drugs, including second-line injections that have proven to be effective. Bedaquiline is a relatively new drug recommended by the World Health Organization (WHO) and European Medicines Agency (EMA) for the treatment of MDR-TB.

Aims and Objectives:

This study examines the cost-effectiveness of using regimens containing bedaquiline compared to those containing second-line injections.

Methods:

The design of this study is a literature review study. The following keywords used for the search were: “MDR-TB,” “cost effectiveness analysis of MDR-TB,” “cost effectiveness analysis of MDR-TB patients,” “WHO guideline for MDR-TB,” “Bedaquiline cost effectiveness,” and “kanamycin cost effectiveness.” The relevant references were derived from several databases, including PubMed, NCBI, and the Journal of Indonesian Health Economics. A total of 170 articles were obtained during the initial search, then extracted with inclusion criteria, namely articles assessing cost effectiveness, QALY, DALY, articles in English and Indonesian, and publications within the last 10 years.

Result and Conclusion:

The addition of bedaquiline in standard therapy showed favourable effect and safety due to faster culture conversion time and less incidence of side effects, based on the results of studies. The faster the culture conversion occurs and the less patients experiencing side effects, the faster their health improvement. Which prospectively will reduce treatment costs and productivity loss. This is demonstrated by the results of cost-effectiveness analysis which shows that the replacement of the second-line injection regimen to bedaquiline, and the addition of bedaquiline to the standard regimen of therapy was assessed to be more cost-effective option.

Keywords: Bedaquiline, Cost-effectiveness, Utility, Second-line injection, Multidrug Resistant Tuberculosis, Review.


Article Information


Identifiers and Pagination:

Year: 2021
Volume: 14
Publisher Item Identifier (PII): BMS-TOPHJ-2021-11

Article History:

Electronic publication date: 12/4/2021
Collection year: 2021

© 2021 Sari et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


* Address correspondence to this author at the Department of Biological Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jl.Raya Bandung-Sumedang Km 21, West Java, Indonesia; E-mails: melisa.barliana@unpad.ac.id


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