ICMR – National Institute of Tuberculosis Research study finds that six-month all-oral regimens for multidrug-resistant and rifampicin-resistant TB (MDR/RR-TB) are cost-effective and provide better health outcomes than longer treatments used in India | Photo credit: File
Shorter all-oral regimens for drug-resistant tuberculosis are cost-effective in India, noted a recent study published by the Indian Council of Medical Research. An economic evaluation published in the Indian Journal of Medical Research found that shorter, six-month all-oral treatment regimens for multidrug-resistant and rifampicin-resistant tuberculosis (MDR/RR-TB) are cost-effective and offer better health outcomes compared to longer regimens currently used in India.
The study was conducted by the ICMR-National Institute for Tuberculosis Research (ICMR-NIRT) and evaluated the cost-effectiveness of bedaquiline-based regimens, BPaL (bedachiline, pretomanide and linezolid) and BPaLM (with moxifloxacin), compared with the existing shorter (9–18 months used by NationalTB) and longer (9–18 months) bedaquiline-containing regimens used by the National TB Program (NTEP).
The analysis revealed that the BPaL regime is more effective and more economical at the same time. For every additional quality-adjusted life-year (QALY) gained, the health system spends ₹379 less per patient compared to the standard regimen, indicating better health outcomes at lower costs.
The BPaLM regimen was also found to be highly cost-effective, with an additional expenditure of only ₹ 37 per patient per additional QALY gained compared to the standard regimen. Both regimens were associated with lower or comparable total health care costs, including medications, hospital visits, and follow-up care. “MDR/RR-TB presents significant treatment challenges due to prolonged treatment duration, adverse effects and higher costs. Shorter all-oral regimens can improve adherence, reduce patient morbidity and enable a faster return to normal life while reducing the burden on the health system,” the study said.
It is concluded that the study results provide important economic evidence to support the use of shorter, all-oral regimens for the treatment of MDR/RR-TB in India. By reducing treatment duration from 9–18 months or longer to six months, these regimens align with national priorities to optimize resource utilization and accelerate progress toward TB elimination.
The study also adds that BPaL-based regimens are likely to be cost-effective or highly cost-effective and may be considered for programmatic adoption under the NTEP to strengthen India’s response to drug-resistant tuberculosis.
Published – 12 Feb 2026 17:33 IST