ICMR study finds shorter TB therapy cuts costs, side effects and death risk: What it means for patients

What did the study find?

The study, published in the Indian Journal of Medical Research, found that the BPaL regimen — which uses a combination of three oral drugs — Bedaquiline, Pretomanid, and Linezolid — could save the health programme Rs 379 per patient for every healthy life-year added. And, for the BPaLM regimen — that adds on another, more expensive antimicrobial Moxifloxacin — the government would have to spend an additional Rs 37 per patient for each additional healthy life-year, the study found.

The findings are based on a model that used the data of 48,563 multi-drug resistant TB patients who were either on BPaL, BPaLM or the standard of care (which included 58% on the longer 18-20 month therapy and 42% on the shorter 9-11 month therapy).

What does this mean for TB patients?

“This is just the cost. When it comes to individual patients, the impact is immense. The treatment duration has gone down to six months, meaning the patients would need fewer trips to their health facilities and would be able to join the workforce sooner. The new therapy regime also reduces the travel costs. Being oral, it spares the patients from injections,” said Dr Malaisamy Muniyandi, senior scientist and head of the department of health economics at ICMR-NIRT.

“The shorter duration also helps the patient re-integrate into the society sooner. There is still a lot of stigma attached to TB and it takes some time to go away even after a patient has completed their treatment,” he added.

How has the treatment of drug-resistant TB improved?

The easier availability of TrueNat and GeneXpert machines, which were used for Covid-19 testing during the pandemic, has helped in quicker diagnosis of not only TB, but whether it is resistant to one of the commonly used drugs, rifampicin. Now, other Rt-PCR tests are also becoming available for TB, says Dr Muniyandi. “Unlike identifying the TB mycobacterium under the microscope, which takes time, the molecular tests can give results within three hours. Importantly, the same test can also tell whether a person is susceptible or resistant to a drug. This means a quicker diagnosis and quicker treatment for even the resistant infections,” he added.