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Journal of Market Access & Health Policy (JMAHP) is published by MDPI from Volume 12 Issue 1 (2024). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Taylor & Francis.
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Article

Cost-Effectiveness of Bedaquiline in MDR and XDR Tuberculosis in Italy

by
Luigi R. Codecasa
1,*,
Mondher Toumi
2,
Anna D’Ausilio
3,
Andrea Aiello
3,
Francesco Damele
4,
Roberta Termini
4,
Alessia Uglietti
4,
Robert Hettle
5,
Giorgio Graziano
6 and
Saverio De Lorenzo
7
1
Regional TB Reference Centre, Villa Marelli Institute/ASST Niguarda Ca’ Granda, Milano, Italy
2
Faculty of Medicine, Public Health Department, Aix-Marseille University, Marseille, France
3
Creativ-Ceutical, Milano, Italy
4
Janssen-Cilag, Cologno Monzese, Italy
5
Parexel International, London, UK
6
Post-graduate Residency School in Hygiene and Preventive Medicine, University of Palermo, Palermo, Italy
7
E. Morelli Hospital ASST, Reference Center for MDR-TB and HIV-TB, Sondalo, Italy
*
Author to whom correspondence should be addressed.
J. Mark. Access Health Policy 2017, 5(1), 1283105; https://doi.org/10.1080/20016689.2017.1283105
Submission received: 7 November 2016 / Revised: 15 December 2016 / Accepted: 22 December 2016 / Published: 17 February 2017

Abstract

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.
Keywords: bedaquiline; cost-effectiveness; MDR tuberculosis; XDR tuberculosis; Italy bedaquiline; cost-effectiveness; MDR tuberculosis; XDR tuberculosis; Italy

Share and Cite

MDPI and ACS Style

Codecasa, L.R.; Toumi, M.; D’Ausilio, A.; Aiello, A.; Damele, F.; Termini, R.; Uglietti, A.; Hettle, R.; Graziano, G.; De Lorenzo, S. Cost-Effectiveness of Bedaquiline in MDR and XDR Tuberculosis in Italy. J. Mark. Access Health Policy 2017, 5, 1283105. https://doi.org/10.1080/20016689.2017.1283105

AMA Style

Codecasa LR, Toumi M, D’Ausilio A, Aiello A, Damele F, Termini R, Uglietti A, Hettle R, Graziano G, De Lorenzo S. Cost-Effectiveness of Bedaquiline in MDR and XDR Tuberculosis in Italy. Journal of Market Access & Health Policy. 2017; 5(1):1283105. https://doi.org/10.1080/20016689.2017.1283105

Chicago/Turabian Style

Codecasa, Luigi R., Mondher Toumi, Anna D’Ausilio, Andrea Aiello, Francesco Damele, Roberta Termini, Alessia Uglietti, Robert Hettle, Giorgio Graziano, and Saverio De Lorenzo. 2017. "Cost-Effectiveness of Bedaquiline in MDR and XDR Tuberculosis in Italy" Journal of Market Access & Health Policy 5, no. 1: 1283105. https://doi.org/10.1080/20016689.2017.1283105

APA Style

Codecasa, L. R., Toumi, M., D’Ausilio, A., Aiello, A., Damele, F., Termini, R., Uglietti, A., Hettle, R., Graziano, G., & De Lorenzo, S. (2017). Cost-Effectiveness of Bedaquiline in MDR and XDR Tuberculosis in Italy. Journal of Market Access & Health Policy, 5(1), 1283105. https://doi.org/10.1080/20016689.2017.1283105

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