Cost-effectiveness of bedaquiline in MDR and XDR tuberculosis in Italy
Objective: To evaluate the cost-effectiveness of bedaquiline plus background drug regimens (BR) for multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) in Italy. Methods: A Markov model was adapted to the Italian setting to estimate the incremental cost-eff...
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| Format: | Article |
| Language: | English |
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MDPI AG
2017-01-01
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| Series: | Journal of Market Access & Health Policy |
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| Online Access: | http://dx.doi.org/10.1080/20016689.2017.1283105 |
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| author | Luigi R. Codecasa Mondher Toumi Anna D’Ausilio Andrea Aiello Francesco Damele Roberta Termini Alessia Uglietti Robert Hettle Giorgio Graziano Saverio De Lorenzo |
| author_facet | Luigi R. Codecasa Mondher Toumi Anna D’Ausilio Andrea Aiello Francesco Damele Roberta Termini Alessia Uglietti Robert Hettle Giorgio Graziano Saverio De Lorenzo |
| author_sort | Luigi R. Codecasa |
| collection | DOAJ |
| description | Objective: To evaluate the cost-effectiveness of bedaquiline plus background drug regimens (BR) for multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) in Italy. Methods: A Markov model was adapted to the Italian setting to estimate the incremental cost-effectiveness ratio (ICER) of bedaquiline plus BR (BBR) versus BR in the treatment of MDR-TB and XDR-TB over 10 years, from both the National Health Service (NHS) and societal perspective. Cost-effectiveness was evaluated in terms of life-years gained (LYG). Clinical data were sourced from trials; resource consumption for compared treatments was modelled according to advice from an expert clinicians panel. NHS tariffs for inpatient and outpatient resource consumption were retrieved from published Italian sources. Drug costs were provided by reference centres for disease treatment in Italy. A 3% annual discount was applied to both cost and effectiveness. Deterministic and probabilistic sensitivity analyses were conducted. Results: Over 10 years, BBR vs. BR alone is cost-effective, with ICERs of €16,639/LYG and €4081/LYG for the NHS and society, respectively. The sensitivity analyses confirmed the robustness of the results from both considered perspectives. Conclusion: In Italy, BBR vs. BR alone has proven to be cost-effective in the treatment of MDR-TB and XDR-TB under a range of scenarios. |
| format | Article |
| id | doaj-art-586d1af3c8034fe99febead63d90c491 |
| institution | Kabale University |
| issn | 2001-6689 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Market Access & Health Policy |
| spelling | doaj-art-586d1af3c8034fe99febead63d90c4912025-08-20T03:33:36ZengMDPI AGJournal of Market Access & Health Policy2001-66892017-01-015110.1080/20016689.2017.12831051283105Cost-effectiveness of bedaquiline in MDR and XDR tuberculosis in ItalyLuigi R. Codecasa0Mondher Toumi1Anna D’Ausilio2Andrea Aiello3Francesco Damele4Roberta Termini5Alessia Uglietti6Robert Hettle7Giorgio Graziano8Saverio De Lorenzo9Villa Marelli Institute/ASST Niguarda Ca’ GrandaAix-Marseille UniversityCreativ-CeuticalCreativ-CeuticalJanssen-CilagJanssen-CilagJanssen-CilagParexel InternationalUniversity of PalermoE. Morelli Hospital ASST, Reference Center for MDR-TB and HIV-TBObjective: To evaluate the cost-effectiveness of bedaquiline plus background drug regimens (BR) for multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) in Italy. Methods: A Markov model was adapted to the Italian setting to estimate the incremental cost-effectiveness ratio (ICER) of bedaquiline plus BR (BBR) versus BR in the treatment of MDR-TB and XDR-TB over 10 years, from both the National Health Service (NHS) and societal perspective. Cost-effectiveness was evaluated in terms of life-years gained (LYG). Clinical data were sourced from trials; resource consumption for compared treatments was modelled according to advice from an expert clinicians panel. NHS tariffs for inpatient and outpatient resource consumption were retrieved from published Italian sources. Drug costs were provided by reference centres for disease treatment in Italy. A 3% annual discount was applied to both cost and effectiveness. Deterministic and probabilistic sensitivity analyses were conducted. Results: Over 10 years, BBR vs. BR alone is cost-effective, with ICERs of €16,639/LYG and €4081/LYG for the NHS and society, respectively. The sensitivity analyses confirmed the robustness of the results from both considered perspectives. Conclusion: In Italy, BBR vs. BR alone has proven to be cost-effective in the treatment of MDR-TB and XDR-TB under a range of scenarios.http://dx.doi.org/10.1080/20016689.2017.1283105Bedaquilinecost-effectivenessMDR tuberculosisXDR tuberculosisItaly |
| spellingShingle | Luigi R. Codecasa Mondher Toumi Anna D’Ausilio Andrea Aiello Francesco Damele Roberta Termini Alessia Uglietti Robert Hettle Giorgio Graziano Saverio De Lorenzo Cost-effectiveness of bedaquiline in MDR and XDR tuberculosis in Italy Journal of Market Access & Health Policy Bedaquiline cost-effectiveness MDR tuberculosis XDR tuberculosis Italy |
| title | Cost-effectiveness of bedaquiline in MDR and XDR tuberculosis in Italy |
| title_full | Cost-effectiveness of bedaquiline in MDR and XDR tuberculosis in Italy |
| title_fullStr | Cost-effectiveness of bedaquiline in MDR and XDR tuberculosis in Italy |
| title_full_unstemmed | Cost-effectiveness of bedaquiline in MDR and XDR tuberculosis in Italy |
| title_short | Cost-effectiveness of bedaquiline in MDR and XDR tuberculosis in Italy |
| title_sort | cost effectiveness of bedaquiline in mdr and xdr tuberculosis in italy |
| topic | Bedaquiline cost-effectiveness MDR tuberculosis XDR tuberculosis Italy |
| url | http://dx.doi.org/10.1080/20016689.2017.1283105 |
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