Evidence map›Paper›PMID 40959787›Full record

ArticleIJTLD open2025

An economic analysis of BPaL for multidrug-resistant TB in South Africa and the Philippines.

S D Masuku, C Nattey, L Coetzee, K Hirasen, A Mabhula, D J Casalme, M T Gler, A Gupta, S Juneja, N Ndjeka and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in IJTLD open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

12 authors.

S D MasukuHealth Economics and Epidemiology Research Office, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
C NatteyHealth Economics and Epidemiology Research Office, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
L CoetzeeHealth Economics and Epidemiology Research Office, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
K HirasenHealth Economics and Epidemiology Research Office, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
A MabhulaHealth Economics and Epidemiology Research Office, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
D J CasalmeDe La Salle Health Sciences Institute, Cavite, Philippines.
M T GlerTB HIV Innovations and Clinical Research Foundation, Cavite, Philippines.
A GuptaTB Alliance, New York, NY, USA.
S JunejaTB Alliance, New York, NY, USA.
N NdjekaTB Control and Management, National Department of Health, Pretoria, South Africa.
D EvansHealth Economics and Epidemiology Research Office, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
B E NicholsDepartment of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe WHO endorses bedaquiline, pretomanid, and linezolid (BPaL)-based regimens for multidrug-resistant/rifampicin-resistant TB, and both the Philippines (PH) and South Africa (SA) have adopted these regimens.

methodsUsing a Markov model, we assessed the cost per successful treatment and 5-year budgetary and economic impact of BPaL-based regimens in SA and PH. Treatment outcomes were informed by national electronic registries, SA BPaL Clinical Access Program, and PH operational research. Costs were estimated from the provider perspective.

resultsOver 5 years, BPaL-based regimens reduce total costs by 20%-25% in SA and 9%-11% in PH compared with a standard short oral regimen (SSOR) when achieving the same number of successful treatments, due to lower cost per successful treatment from reduced loss to follow-up and mortality. BPaL-based regimens improve treatment success by 22%, leading to more patients completing full treatment and higher overall resource use. Therefore, the budget for BPaL-based regimens is projected to increase by 7%-8% (SA) and 6% (PH) from 2023/24 to 2027/28.

conclusionBPaL-based regimens reduce cost per successful treatment compared with SSOR and require smaller budgets for similar treatment outcomes. Implementation may involve initial budget increases, but improvements in treatment success and long-term health outcomes outweigh these costs, presenting a strong rationale for rollout.

Indexed as

bedaquilineBPaLbudget impacteconomic impactMDR-TBtuberculosis

Identifiers

PMID40959787
PMCPMC12435464

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.