6533b862fe1ef96bd12c6315

RESEARCH PRODUCT

Cost-effectiveness of bedaquiline in MDR and XDR tuberculosis in Italy

Mondher ToumiFrancesco DameleLuigi CodecasaA AielloRoberta TerminiSaverio De LorenzoRobert HettleAlessia UgliettiGiorgio GrazianoA D'ausilio

subject

medicine.medical_specialtyPediatricsTuberculosisCost effectivenessBedaquilinelcsh:Business03 medical and health scienceschemistry.chemical_compound0302 clinical medicineSocietal perspectivemedicineOriginal Research Article030212 general & internal medicineResource consumptionSensitivity analysescost-effectivenessDisease treatmenthealth care economics and organizationsbusiness.industrylcsh:Public aspects of medicinelcsh:RA1-1270medicine.diseaseNational health serviceMDR tuberculosis030228 respiratory systemchemistryItalyEmergency medicineXDR tuberculosisOriginal ArticleBedaquilinebusinesslcsh:HF5001-6182

description

ABSTRACT Objective: To evaluate the cost-effectiveness of bedaquiline plus background drug regimens (BR) for multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) in Italy. Methods: A Markov model was adapted to the Italian setting to estimate the incremental cost-effectiveness ratio (ICER) of bedaquiline plus BR (BBR) versus BR in the treatment of MDR-TB and XDR-TB over 10 years, from both the National Health Service (NHS) and societal perspective. Cost-effectiveness was evaluated in terms of life-years gained (LYG). Clinical data were sourced from trials; resource consumption for compared treatments was modelled according to advice from an expert clinicians panel. NHS tariffs for inpatient and outpatient resource consumption were retrieved from published Italian sources. Drug costs were provided by reference centres for disease treatment in Italy. A 3% annual discount was applied to both cost and effectiveness. Deterministic and probabilistic sensitivity analyses were conducted. Results: Over 10 years, BBR vs. BR alone is cost-effective, with ICERs of €16,639/LYG and €4081/LYG for the NHS and society, respectively. The sensitivity analyses confirmed the robustness of the results from both considered perspectives. Conclusion: In Italy, BBR vs. BR alone has proven to be cost-effective in the treatment of MDR-TB and XDR-TB under a range of scenarios.

yearjournalcountryeditionlanguage
2016-11-07Journal of Market Access & Health Policy
10.1080/20016689.2017.1283105https://doaj.org/article/586d1af3c8034fe99febead63d90c491