Evidence map›Paper›PMID 35961488›Full record

ArticleClinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases2023

Availability and costs of medicines for the treatment of tuberculosis in Europe.

Gunar Günther, Lorenzo Guglielmetti, Claude Leu, Christoph Lange, Frank van Leth, Tuberculosis Network European Trials group

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 2 pooled it
4.7field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 2 syntheses or guidelines pooled it, 47 citations in OpenAlex.

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  19. Availability of drugs for the treatment of multidrug-resistant/rifampicin-resistant tuberculosis in the World Health Organization European Region, October 2023.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2024
    Article
  20. Multidrug-resistant tuberculosis.Nature reviews. Disease primers · 2024
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 20 institutions in 41 countries.

Gunar GüntherDepartment of Pulmonary Medicine and Allergology, Inselspital, Bern University Hospital, University of Bern, Switzerland; Department of Medical Sciences, School of Medicine, University of Namibia, Windhoek, Namibia.
Lorenzo GuglielmettiSorbonne Université, INSERM, U1135, Centre d'Immunologie et des Maladies Infectieuses, Cimi-Paris, équipe 2, Paris, France; Assistance Publique - Hôpitaux de Paris, Groupe Hospitalier Universitaire Sorbonne Université, Hôpital Pitié-Salpêtrière, Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Paris, France.
Claude LeuDepartment of Pulmonary Medicine and Allergology, Inselspital, Bern University Hospital, University of Bern, Switzerland.
Christoph LangeDivision of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany; German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Borstel, Germany; Respiratory Medicine and International Health, University of Lübeck, Lübeck, Germany; Baylor College of Medicine and Texas Children´s Hospital, Global TB Program, Houston, TX, USA. Electronic address: clange@fz-borstel.de.
Frank van LethDepartment of Health Sciences, Faculty of Science, Vrije Universiteit, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
Tuberculosis Network European Trials group
National Center for Tuberculosis and Lung Disease · GEAzienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda · ITCharles University · CZNational University Hospital of Iceland · ISNicosia General Hospital · CYRepublican Scientific and Practical Centre of Pulmonology and Tuberculosis · BYUniversity Hospital of Bern · CHAlterSanté · FRG. Papanikolaou General Hospital · GROslo University Hospital · NOResearch Center Borstel - Leibniz Lung Center · DEStatens Serum Institut · DKTartu University Hospital · EEUniversity of Groningen · NLVolgograd State Medical University · RUAgència de Salut Pública de Catalunya · ESBarts Health NHS Trust · GBCentral Statistics Office · IECentre Hospitalier de Luxembourg · LUCentro Hospitalar Lisboa Norte · PT

Funding

Emory-Georgia TB Research Training ProgramD43TW007124 · FIC · EMORY UNIVERSITY · PI HENRY M BLUMBERG, Nestani Tukvadze · 2004 to 2026
$4.6M
FIC NIH HHS D43 TW007124
6 · The paper itself

Abstract

objectivesTo evaluate the access to comprehensive diagnostics and novel antituberculosis medicines in European countries.

methodsWe investigated the access to genotypic and phenotypic Mycobacterium tuberculosis drug susceptibility testing and the availability of antituberculosis drugs and calculated the cost of drugs and treatment regimens at major tuberculosis treatment centres in countries of the WHO European region where rates of drug-resistant tuberculosis are the highest among all WHO regions. Results were stratified by middle-income and high-income countries.

resultsOverall, 43 treatment centres from 43 countries participated in the study. For WHO group A drugs, the frequency of countries with the availability of phenotypic drug susceptibility testing was as follows: (a) 75% (30/40) for levofloxacin, (b) 82% (33/40) for moxifloxacin, (c) 48% (19/40) for bedaquiline, and (d) 72% (29/40) for linezolid. Overall, of the 43 countries, 36 (84%) and 24 (56%) countries had access to bedaquiline and delamanid, respectively, whereas only 6 (14%) countries had access to rifapentine. The treatment of patients with extensively drug-resistant tuberculosis with a regimen including a carbapenem was available only in 17 (40%) of the 43 countries. The median cost of regimens for drug-susceptible tuberculosis, multidrug-resistant/rifampicin-resistant tuberculosis (shorter regimen, including bedaquiline for 6 months), and extensively drug-resistant tuberculosis (including bedaquiline, delamanid, and a carbapenem) were €44 (minimum-maximum, €15-152), €764 (minimum-maximum, €542-15152), and €8709 (minimum-maximum, €7965-11759) in middle-income countries (n = 12) and €280 (minimum-maximum, €78-1084), €29765 (minimum-maximum, €11116-40584), and €217591 (minimum-maximum, €82827-320146) in high-income countries (n = 29), respectively. DISCUSSION: In countries of the WHO European region, there is a widespread lack of drug susceptibility testing capacity to new and repurposed antituberculosis drugs, lack of access to essential medications in several countries, and a high cost for the treatment of drug-resistant tuberculosis.

Indexed as

Extensively Drug-Resistant TuberculosisMycobacterium tuberculosisTuberculosis, Multidrug-ResistantAntitubercular AgentsEuropeHumansMicrobial Sensitivity TestsNitroimidazolesOxazolesAntitubercular AgentsNitroimidazolesOPC-67683OxazolesAntimicrobial resistanceAvailability of medicinesCapacity buildingCostsEND-TB strategyMDR-TBMedicinesTuberculosis

Identifiers

PMID35961488
PMCPMC9801521
OpenAlexW4291708189

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.