Cost-Effectiveness Analysis of Combined Chemotherapy Regimen Containing Bedaquiline in the Treatment of Multidrug-Resistant Tuberculosis in China.

Cai Hong XU; Ying Peng Qiu; Zi Long HE; Dong Mei HU; Xiao Yue; Zhong Dan Chen; Yuan Yuan XU; Yan Lin Zhao

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Cost-Effectiveness Analysis of Combined Chemotherapy Regimen Containing Bedaquiline in the Treatment of Multidrug-Resistant Tuberculosis in China.

Author: Cai Hong XU ¹ ; Ying Peng QIU ^{2
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3} ; Zi Long HE ⁴ ; Dong Mei HU ¹ ; Xiao YUE ⁵ ; Zhong Dan CHEN ⁶ ; Yuan Yuan XU ¹ ; Yan Lin ZHAO ^{2
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Author Information

1. National Center for Tuberculosis Control and Prevention, China CDC, Beijing 100226, China.
2. China National Health Development Research Center, Beijing 100226, China
3. The University of Sheffield, S10 2TN, Sheffield, The United Kingdom.
4. The Central South University, Changsha 410083, Hunan, China.
5. China National Health Development Research Center, Beijing 100226, China.
6. World Health Organization Representative Office for China, Beijing 100600, China.
7. National Center for Tuberculosis Control and Prevention, China CDC, Beijing 100226, China
8. The University of Sheffield, S10 2TN, Sheffield, The United Kingdom
9. The Central South University, Changsha 410083, Hunan, China
Publication Type:Journal Article
Keywords: Bedaquiline; China; Cost-effectiveness; Multidrug-resistant tuberculosis
MeSH: Adult; Humans; Antitubercular Agents/therapeutic use*; Cost-Effectiveness Analysis; Cost-Benefit Analysis; Tuberculosis, Multidrug-Resistant/drug therapy*; China/epidemiology*
From: Biomedical and Environmental Sciences 2023;36(6):501-509
CountryChina
Language:English
Abstract: OBJECTIVE:This study aims to estimate the cost-effectiveness of the combined chemotherapy regimen containing Bedaquiline (BR) and the conventional treatment regimen (CR, not containing Bedaquiline) for the treatment of adults with multidrug-resistant tuberculosis (MDR-TB) in China.
METHODS:A combination of a decision tree and a Markov model was developed to estimate the cost and effects of MDR patients in BR and CR within ten years. The model parameter data were synthesized from the literature, the national TB surveillance information system, and consultation with experts. The incremental cost-effectiveness ratio (ICER) of BR vs. CR was determined.
RESULTS:BR ( vs. CR) had a higher sputum culture conversion rate and cure rate and prevented many premature deaths (decreased by 12.8%), thereby obtaining more quality-adjusted life years (QALYs) (increased by 2.31 years). The per capita cost in BR was as high as 138,000 yuan, roughly double that of CR. The ICER for BR was 33,700 yuan/QALY, which was lower than China's 1× per capita Gross Domestic Product (GDP) in 2020 (72,400 yuan).
CONCLUSION:BR is shown to be cost effective. When the unit price of Bedaquiline reaches or falls below 57.21 yuan per unit, BR is expected to be the dominant strategy in China over CR.