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

Kavina Manalan, Nathan Green, Amber Arnold*, Graham S. Cooke, Martin Dedicoat, Marc Lipman, Angela Loyse, Tom S. Harrison, Onn Min Kon

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

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 £27,236 (4952) for the observed injectable group, £30,264 (3392) and 36,309 (3901) for the 6 and 8 month amikacin groups, and £31,760 (2092) for the bedaquiline group. The cost in the bedaquiline group was £30,772 (1855) with a 10% reduction and £27,079 (1234) with a 33% reduction 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.

Original languageEnglish
Pages (from-to)38-41
Number of pages4
JournalJournal of Infection
Volume80
Issue number1
DOIs
Publication statusPublished - Jan 2020
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2019

Keywords

  • Bedaquiline
  • MDR-TB
  • Tuberculosis

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