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A cost comparison of amikacin therapy with bedaquiline, for drug-resistant tuberculosis in the UK.

Manalan, K; Green, N; Arnold, A; Cooke, GS; Dedicoat, M; Lipman, M; Loyse, A; Harrison, TS; Kon, OM (2020) A cost comparison of amikacin therapy with bedaquiline, for drug-resistant tuberculosis in the UK. J Infect, 80 (1). pp. 38-41. ISSN 1532-2742 https://doi.org/10.1016/j.jinf.2019.09.006
SGUL Authors: Harrison, Thomas Stephen

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Abstract

OBJECTIVES: Prioritisation of oral bedaquiline over the injectable agents in the treatment of multidrug-resistant Tuberculosis (MDR-TB) in the World Health Organisations (WHO) 2019 guidelines prompted this UK analysis of cost implications. The objective was to estimate the costs of amikacin versus bedaquiline in MDR TB treatment regimens using a historical cohort where the injectable agents were the standard of care. METHODS: This was a retrospective study using a known cohort of UK patients treated with an injectable agent, with data available on resource use, costs for the use of amikacin were compared with those for bedaquiline, based on recommended monitoring for bedaquiline. RESULTS: The estimated cost of treatment per patient had mean (sd) of £27236 (4952) for the observed injectable group, £30264 (3392) and 36309 (3901) for the 6 and 8 month amikacin groups, and £31760 (2092) for the bedaquiline group. The cost in the bedaquiline group was £30772 (1855) with a 10 % reduction and £27079 (1234) with a 33% reduction in in-patient stay. CONCLUSIONS: In most scenarios, bedaquiline is close to cost neutral compared with injectable therapy, especially if, as expected, some reduction in duration of admission is possible as a result of bedaquiline's more rapid culture conversion.

Item Type: Article
Additional Information: © 2019. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Keywords: MDR-TB, Tuberculosis, bedaquiline, MDR-TB, Tuberculosis, bedaquiline, Microbiology, 1103 Clinical Sciences
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: J Infect
ISSN: 1532-2742
Language: eng
Dates:
DateEvent
January 2020Published
21 September 2019Published Online
17 September 2019Accepted
Publisher License: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
PubMed ID: 31550466
Go to PubMed abstract
URI: http://openaccess.sgul.ac.uk/id/eprint/111269
Publisher's version: https://doi.org/10.1016/j.jinf.2019.09.006

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