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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; ... Kon, OM; + view all (2020) A cost comparison of amikacin therapy with bedaquiline, for drug-resistant tuberculosis in the UK. Journal of Infection , 80 (1) pp. 38-41. 10.1016/j.jinf.2019.09.006. Green open access

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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 £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.

Type: Article
Title: A cost comparison of amikacin therapy with bedaquiline, for drug-resistant tuberculosis in the UK
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.jinf.2019.09.006
Publisher version: https://doi.org/10.1016/j.jinf.2019.09.006
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Bedaquiline, MDR-TB, Tuberculosis
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Respiratory Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10085758
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