Park, H.-Y. orcid.org/0000-0001-8348-0887, Kwon, J.-W. orcid.org/0000-0003-3467-7805, Kim, H.-L. orcid.org/0000-0001-9091-8787 et al. (6 more authors) (2023) Cost-effectiveness of all-oral regimens for the treatment of multidrug-resistant tuberculosis in Korea: comparison with conventional injectable-containing regimens. Journal of Korean Medical Science, 38 (21). e167. ISSN 1011-8934
Abstract
Background
Regimens for the treatment of multidrug-resistant tuberculosis (MDR-TB) have been changed from injectable-containing regimens to all-oral regimens. The economic effectiveness of new all-oral regimens compared with conventional injectable-containing regimens was scarcely evaluated. This study was conducted to compare the cost-effectiveness between all-oral longer-course regimens (the oral regimen group) and conventional injectable-containing regimens (the control group) to treat newly diagnosed MDR-TB patients.
Methods
A health economic analysis over lifetime horizon (20 years) from the perspective of the healthcare system in Korea was conducted. We developed a combined simulation model of a decision tree model (initial two years) and two Markov models (remaining 18 years, six-month cycle length) to calculate the incremental cost-effectiveness ratio (ICER) between the two groups. The transition probabilities and cost in each cycle were assumed based on the published data and the analysis of health big data that combined country-level claims data and TB registry in 2013–2018. Results: The oral regimen group was assumed to spend 20,778 USD more and lived 1.093 years or 1.056 quality-adjusted life year (QALY) longer than the control group. The ICER of the base case was calculated to be 19,007 USD/life year gained and 19,674 USD/QALY. The results of sensitivity analyses showed that base case results were very robust and stable, and the oral regimen was cost-effective with a 100% probability for a willingness to pay more than 21,250 USD/QALY.
Conclusion
This study confirmed that the new all-oral longer regimens for the treatment of MDR-TB were cost-effective in replacing conventional injectable-containing regimens.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2023 The Korean Academy of Medical Sciences. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https:// creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
Keywords: | Cost Analysis; Health Economics; Multidrug-Resistant Tuberculosis; Tuberculosis; Humans; Cost-Benefit Analysis; Tuberculosis, Multidrug-Resistant; Clinical Protocols; Republic of Korea; Quality-Adjusted Life Years |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Medicine and Population Health |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 30 Jan 2024 12:23 |
Last Modified: | 30 Jan 2024 12:23 |
Status: | Published |
Publisher: | XMLink |
Refereed: | Yes |
Identification Number: | 10.3346/jkms.2023.38.e167 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:207994 |