Shorter TB Regimens Reduce Costs in India: ICMR Study

The analysis found that the BPaL regimen was both more effective and cost-saving. For every additional Quality Adjusted Life Year (QALY) gained, the health system saved INR 379 per patient compared to the current standard regimen. This indicates better health outcomes at a lower overall cost.

The BPaLM regimen was also highly cost-effective, requiring an additional expenditure of only INR 37 per patient per additional QALY gained. Both regimens were associated with lower or comparable total healthcare costs, including medication, hospital visits, and follow-up care.

MDR/RR-TB presents major challenges due to prolonged treatment duration, adverse drug effects, and high financial burden. Shorter, all-oral regimens may improve adherence, reduce complications, and allow patients to return to normal activities sooner. By reducing treatment duration to six months, these regimens support more efficient use of healthcare resources and align with India’s national TB elimination goals.

The study concludes that BPaL-based regimens are likely to be cost-saving or highly cost-effective and should be considered for broader programmatic adoption under NTEP to strengthen India’s response to drug-resistant tuberculosis.

REFERENCE: Malaisamy Muniyandi, Karikalan Nagarajan, Karthick Chelvanayagam. Kavitha Rajsekar, Kirti Tyagi, Chandrasekaran Padmapriyadarsini; Cost-effectiveness of BPaL/BPaLM as compared to mixed standard of care bedaquiline containing regimen for MDR/RR-TB; Indian Journal of Medical Research; doi: 10.25259/IJMR_158_2025