By Sharon Atieno

With drug-resistant Tuberculosis (DR-TB) affecting about 440,000 people yearly, a new treatment regimen could save governments up to US$740 million annually.

This is according to a new study published in PLOS Global Public Health which found that the cost of implementing this new treatment regimen called BPaLM/BPaL is potentially 40-90% less expensive than current regimens.

The BPaLM/BPaL consists of bedaquiline, pretomanid, linezolid and moxifloxacin, with the provision of dropping moxifloxacin in case of confirmed resistance to fluoroquinolones. The regimen shortens the time needed for treatment to six months, an improvement that helps increase adherence to the treatment.

Of those who are able to access therapy, more than 40% were unable to complete it successfully due in part to the lengthy and complex treatment that presents significant challenges both to compliance and to healthcare systems that must administer the therapy and follow up with patients for up to an additional 18 months or more, the report notes.

“TB is a difficult disease to cure, requiring a combination of medicines that all have different ways of eliminating a bacterium that is absolutely tenacious,” said Sandeep Juneja, a co-author of the study and Senior Vice President, Market Access, of TB Alliance in a statement.

“We already knew that 6-month therapy makes a difference for people affected by this deadly infectious disease. What this new data now tells us is that they also lead to significantly lower healthcare costs for governments, as well as a reduction in the costs incurred by patients and their families. Moreover, the significant savings generated by switching to short therapies will help health systems bridge the gap in TB care.”

According to the World Health Organization (WHO), in its May 2022 Rapid Communication, BPaLM may be used programmatically for all people with rifampicin-resistant TB who are14 years and older, and have not had previous exposure of more than one month to bedaquiline, pretomanid and linezolid.

Also, moxifloxacin may be dropped in case of known resistance to fluoroquinolones (that is, pre-XDR-TB). BPaLM/BPaL may be used in place of the previously recommended 9–11 months shorter treatment regimen (STR) and 18–24 months longer treatment regimens (LTR).