A cost comparison of amikacin therapy with bedaquiline, for drug-resistant tuberculosis. How the 2019 WHO recommendations impact UK costs

Background

Prioritisation of oral bedaquiline over the injectable agents in the
treatment of multidrug-resistant Tuberculosis (MDR-TB) in the World
Health Organisations (WHO) 2019 guidelines prompted this UK analysis of
cost implications. Using a known cohort of UK patients treated with an
injectable agent, with data available on resource use, costs for the use
of amikacin were compared with those for bedaquiline, based on
recommended monitoring for bedaquiline. In most scenarios, bedaquiline
is close to cost neutral compared with injectable therapy, especially
if, as expected, some reduction in duration of admission is possible as
a result of more rapid culture conversion.

Analysis

• The patient costs analysis can be found
  here
• Details of the Bayesian modelling using jags can be found
  here

Installation

You can install the GitHub version of AMK-BDQ-cost-analysis with:

devtools::install_github("n8thangreen/AMK-BDQ-cost-analysis")

Output

The final paper is

• K. Manalan, N. Green and A. Arnold et al., A cost comparison of
  amikacin therapy with bedaquiline, for drug resistant tuberculosis
  in the UK, Journal of Infection,
  https://doi.org/10.1016/j.jinf.2019.09.006