Ashhar Alam/New Delhi

A recent study by the Indian Council of Medical Research (ICMR) shows that six-month all-oral treatment regimens for multidrug-resistant (MDR) and rifampicin-resistant (RR) tuberculosis are not only more cost-effective but also deliver better health outcomes compared to the longer therapies currently used in India.

The economic evaluation, conducted by ICMR’s National Institute for Research in Tuberculosis (NIRT) and published in the Indian Journal of Medical Research (IJMR), compared the shorter bedaquiline-based regimens, BPaL (bedaquiline, pretomanid, and linezolid) and BPaLM (including moxifloxacin) with the standard nine-to-11-month and 18-to-20-month regimens under the National TB Elimination Programme (NTEP).

Medicines (Representational Image)

Findings revealed that the six-month BPaL regimen is both more effective and more economical, reducing costs by Rs 379 per patient for each additional quality-adjusted life year (QALY) gained. The BPaLM regimen was also highly cost-efficient, requiring just Rs 37 extra per patient per additional QALY compared to conventional treatment. Overall, both shorter oral regimens were associated with lower or comparable healthcare expenses, covering medicines, hospital visits, and follow-up care.

MDR/RR-TB has long posed challenges in India due to prolonged treatment durations, high costs, and adverse effects that affect patient adherence. Shorter all-oral regimens, the study notes, can improve treatment compliance, reduce morbidity, and allow patients to return to normal life faster, while easing the financial and logistical burden on the health system.

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The study provides strong economic evidence supporting programmatic adoption of shorter, all-oral regimens under NTEP. By cutting treatment to six months, these regimens align with national goals of optimizing resources and accelerating India’s fight against drug-resistant tuberculosis.

BPaL-based therapies are not only cost-saving but also highly effective, making them a viable candidate for wider implementation in India’s TB management programs.