IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0120763.html
   My bibliography  Save this article

Cost-Effectiveness of Adding Bedaquiline to Drug Regimens for the Treatment of Multidrug-Resistant Tuberculosis in the UK

Author

Listed:
  • Lara J Wolfson
  • Anna Walker
  • Robert Hettle
  • Xiaoyan Lu
  • Chrispin Kambili
  • Andrew Murungi
  • Gerhart Knerer

Abstract

Objective: To evaluate the cost-effectiveness of adding bedaquiline to a background regimen (BR) of drugs for multidrug-resistant tuberculosis (MDR-TB) in the United Kingdom (UK). Methods: A cohort-based Markov model was developed to estimate the incremental cost-effectiveness ratio of bedaquiline plus BR (BBR) versus BR alone (BR) in the treatment of MDR-TB, over a 10-year time horizon. A National Health Service (NHS) and personal social services perspective was considered. Cost-effectiveness was evaluated in terms of Quality-Adjusted Life Years (QALYs) and Disability-Adjusted Life Years (DALYs). Data were sourced from a phase II, placebo-controlled trial, NHS reference costs, and the literature; the US list price of bedaquiline was used and converted to pounds (£18,800). Costs and effectiveness were discounted at a rate of 3.5% per annum. Probabilistic and deterministic sensitivity analysis was conducted. Results: The total discounted cost per patient (pp) on BBR was £106,487, compared with £117,922 for BR. The total discounted QALYs pp were 5.16 for BBR and 4.01 for BR. The addition of bedaquiline to a BR resulted in a cost-saving of £11,434 and an additional 1.14 QALYs pp over a 10-year period, and is therefore considered to be the dominant (less costly and more effective) strategy over BR. BBR remained dominant in the majority of sensitivity analyses, with a 81% probability of being dominant versus BR in the probabilistic analysis. Conclusions: In the UK, bedaquiline is likely to be cost-effective and cost-saving, compared with the current MDR-TB standard of care under a range of scenarios. Cost-savings over a 10-year period were realized from reductions in length of hospitalization, which offset the bedaquiline drug costs. The cost-benefit conclusions held after several sensitivity analyses, thus validating assumptions made, and suggesting that the results would hold even if the actual price of bedaquiline in the UK were higher than in the US.

Suggested Citation

  • Lara J Wolfson & Anna Walker & Robert Hettle & Xiaoyan Lu & Chrispin Kambili & Andrew Murungi & Gerhart Knerer, 2015. "Cost-Effectiveness of Adding Bedaquiline to Drug Regimens for the Treatment of Multidrug-Resistant Tuberculosis in the UK," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-20, March.
    • Handle: RePEc:plo:pone00:0120763
    DOI: 10.1371/journal.pone.0120763
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0120763
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0120763&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0120763?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Stephen C Resch & Joshua A Salomon & Megan Murray & Milton C Weinstein, 2006. "Cost-Effectiveness of Treating Multidrug-Resistant Tuberculosis," PLOS Medicine, Public Library of Science, vol. 3(7), pages 1-1, July.
    2. Paul Kind & Geoffrey Hardman & Susan Macran, 1999. "UK population norms for EQ-5D," Working Papers 172chedp, Centre for Health Economics, University of York.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. T. I. Armina Padmasawitri & Sarah Maria Saragih & Gerardus W. Frederix & Olaf Klungel & Anke M. Hövels, 2020. "Managing Uncertainties Due to Limited Evidence in Economic Evaluations of Novel Anti-Tuberculosis Regimens: A Systematic Review," PharmacoEconomics - Open, Springer, vol. 4(2), pages 223-233, June.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Bishal Mohindru & David Turner & Tracey Sach & Diana Bilton & Siobhan Carr & Olga Archangelidi & Arjun Bhadhuri & Jennifer A. Whitty, 2020. "Health State Utility Data in Cystic Fibrosis: A Systematic Review," PharmacoEconomics - Open, Springer, vol. 4(1), pages 13-25, March.
    2. Dina Jankovic & Pedro Saramago Goncalves & Lina Gega & David Marshall & Kath Wright & Meena Hafidh & Rachel Churchill & Laura Bojke, 2022. "Cost Effectiveness of Digital Interventions for Generalised Anxiety Disorder: A Model-Based Analysis," PharmacoEconomics - Open, Springer, vol. 6(3), pages 377-388, May.
    3. Billingsley Kaambwa & Julie Ratcliffe, 2018. "Predicting EuroQoL 5 Dimensions 5 Levels (EQ-5D-5L) Utilities from Older People’s Quality of Life Brief Questionnaire (OPQoL-Brief) Scores," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 11(1), pages 39-54, February.
    4. Carsten Hirt & Sergio Iannazzo & Silvia Chiroli & Lisa J. McGarry & Philipp Coutre & Leif Stenke & Torsten Dahlén & Jeffrey H. Lipton, 2019. "Cost Effectiveness of the Third-Generation Tyrosine Kinase Inhibitor (TKI) Ponatinib, vs. Second-Generation TKIs or Stem Cell Transplant, as Third-Line Treatment for Chronic-Phase Chronic Myeloid Leuk," Applied Health Economics and Health Policy, Springer, vol. 17(4), pages 555-567, August.
    5. Billingsley Kaambwa & Gang Chen & Julie Ratcliffe & Angelo Iezzi & Aimee Maxwell & Jeff Richardson, 2017. "Mapping Between the Sydney Asthma Quality of Life Questionnaire (AQLQ-S) and Five Multi-Attribute Utility Instruments (MAUIs)," PharmacoEconomics, Springer, vol. 35(1), pages 111-124, January.
    6. Donna Rowen & John Brazier & Clara Mukuria & Anju Keetharuth & Arne Risa Hole & Aki Tsuchiya & Sophie Whyte & Phil Shackley, 2016. "Eliciting Societal Preferences for Weighting QALYs for Burden of Illness and End of Life," Medical Decision Making, , vol. 36(2), pages 210-222, February.
    7. Stefano Capri, 2013. "The economics of orphan drugs: the case of osteosarcoma treatment," LIUC Papers in Economics 265, Cattaneo University (LIUC).
    8. Miqdad Asaria & Susan Griffin & Richard Cookson, 2013. "Distributional cost-effectiveness analysis: a tutorial," Working Papers 092cherp, Centre for Health Economics, University of York.
    9. Paul Wallace & Elizabeth Murray & Jim McCambridge & Zarnie Khadjesari & Ian R White & Simon G Thompson & Eleftheria Kalaitzaki & Christine Godfrey & Stuart Linke, 2011. "On-line Randomized Controlled Trial of an Internet Based Psychologically Enhanced Intervention for People with Hazardous Alcohol Consumption," PLOS ONE, Public Library of Science, vol. 6(3), pages 1-8, March.
    10. Bromley, Hannah L. & Petrie, Dennis & Mann, G.Bruce & Nickson, Carolyn & Rea, Daniel & Roberts, Tracy E., 2019. "Valuing the health states associated with breast cancer screening programmes: A systematic review of economic measures," Social Science & Medicine, Elsevier, vol. 228(C), pages 142-154.
    11. Donna Rowen & John Brazier & Aki Tsuchiya & Tracey Young & Rachel Ibbotson, 2012. "It’s All in the Name, or Is It? The Impact of Labeling on Health State Values," Medical Decision Making, , vol. 32(1), pages 31-40, January.
    12. John Brazier & Donna Rowen & Yaling Yang & Aki Tsuchiya, 2012. "Comparison of health state utility values derived using time trade-off, rank and discrete choice data anchored on the full health-dead scale," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(5), pages 575-587, October.
    13. Irmgard C. Schiller-Frühwirth & Beate Jahn & Marjan Arvandi & Uwe Siebert, 2017. "Cost-Effectiveness Models in Breast Cancer Screening in the General Population: A Systematic Review," Applied Health Economics and Health Policy, Springer, vol. 15(3), pages 333-351, June.
    14. Simon, Judit & Anand, Paul & Gray, Alastair & Rugkåsa, Jorun & Yeeles, Ksenija & Burns, Tom, 2013. "Operationalising the capability approach for outcome measurement in mental health research," Social Science & Medicine, Elsevier, vol. 98(C), pages 187-196.
    15. Bram L. T. Ramaekers & Rob Riemsma & Sabine Grimm & Debra Fayter & Sohan Deshpande & Nigel Armstrong & Willem Witlox & Xavier Pouwels & Steven Duffy & Gill Worthy & Jos Kleijnen & Manuela A. Joore, 2019. "Arsenic Trioxide for Treating Acute Promyelocytic Leukaemia: An Evidence Review Group Perspective of a NICE Single Technology Appraisal," PharmacoEconomics, Springer, vol. 37(7), pages 887-894, July.
    16. Helen Dakin & Morris Sherman & Scott Fung & Carrie Fidler & Anthony Bentley, 2011. "Cost Effectiveness of Tenofovir Disoproxil Fumarate for the Treatment of Chronic Hepatitis B from a Canadian Public Payer Perspective," PharmacoEconomics, Springer, vol. 29(12), pages 1075-1091, December.
    17. A C Bouman & A J ten Cate-Hoek & B L T Ramaekers & M A Joore, 2015. "Sample Size Estimation for Non-Inferiority Trials: Frequentist Approach versus Decision Theory Approach," PLOS ONE, Public Library of Science, vol. 10(6), pages 1-14, June.
    18. Böckerman, Petri & Johansson, Edvard & Saarni, Samuli I., 2011. "Do established health-related quality-of-life measures adequately capture the impact of chronic conditions on subjective well-being?," Health Policy, Elsevier, vol. 100(1), pages 91-95, April.
    19. J. P. Sevilla & Daniel Tortorice & David Kantor & John Regan & Kinga H. Meszaros & Ekkehard C. Beck & Najida Begum & David E. Bloom, 2024. "Lifecycle model-based evaluation of infant 4CMenB vaccination in the UK," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 25(7), pages 1133-1146, September.
    20. Thomas Delea & Paul Tappenden & Oleg Sofrygin & Dominy Browning & Mayur Amonkar & Jon Karnon & Mel Walker & David Cameron, 2012. "Cost-effectiveness of lapatinib plus capecitabine in women with HER2+ metastatic breast cancer who have received prior therapy with trastuzumab," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(5), pages 589-603, October.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0120763. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.