A recent study by the Indian Council of Medical Research (ICMR) has found that shorter, six-month, all-oral treatment regimens for multidrug-resistant and rifampicin-resistant tuberculosis (MDR/RR-TB) are both cost-effective and clinically superior to longer regimens.
The study, released on Thursday, highlights that for each additional Quality Adjusted Life Year (QALY) gained, the health system spends Rs 379 less per patient under the shorter regimen compared to standard therapies, reflecting better outcomes at lower costs, according to the Ministry of Health and Family Welfare.
Researchers evaluated bedaquiline-based regimens, specifically BPaL (bedaquiline, pretomanid, and linezolid), against existing shorter (9–11 months) and longer (18–20 months) regimens currently employed under the National TB Elimination Programme (NTEP). BPaLM, which includes moxifloxacin, was also compared and found highly cost-effective, incurring only Rs 37 additional per patient per extra QALY gained compared to standard regimens.
Both BPaL and BPaLM regimens demonstrated lower or comparable overall healthcare costs, factoring in medications, hospital visits, and follow-up care, while offering faster clinical recovery.
MDR/RR-TB presents significant challenges due to extended treatment periods, adverse side effects, and higher costs, which often hinder patient adherence. Shorter, all-oral regimens reduce treatment duration to six months, improving adherence, lowering patient morbidity, and enabling a quicker return to daily life. The findings also highlight reduced strain on the public health system.
“The study provides vital economic evidence supporting the adoption of shorter, all-oral regimens for MDR and RR-TB management in India. Reducing treatment from 9–18 months or longer to six months aligns with national priorities to optimise resources and accelerate TB elimination,” the Ministry statement said.
Current options for rifampicin-resistant TB are limited, with existing regimens often poorly tolerated. The study underscores the potential of newer oral therapies to transform treatment paradigms and outcomes for resistant TB cases.
Separately, Delhi’s Intermediate Reference Laboratory, Tuberculosis Centre, has been certified by the Central Tuberculosis Division (CTD) to conduct Drug Susceptibility Testing (DST) for bedaquiline and pretomanid, strengthening India’s capacity to monitor and implement these modern TB treatments.
The ICMR findings are expected to guide policy decisions and programme implementation under the NTEP, offering a roadmap for cost-efficient, patient-centered TB care in India while accelerating progress toward national TB elimination goals.
