Abstract:

This paper systematically reviews advances in health economic research on pharmacotherapy for rifampicin-resistant/multidrug-resistant tuberculosis (RR/MDR-TB). By sorting out economic evaluation evidence concerning conventional second-line anti-TB regimens, short-course all-oral regimens containing new anti-TB drugs (including bedaquiline-containing regimens, delamanid-containing regimens, BPaL regimen (B: bedaquiline; Pa: pretomanid; L: linezolid) and BPaLM regimen (M: moxifloxacin)), as well as patient management models (such as digital directly observed treatment and community-based management), this article summarizes the costs, effectiveness and cost-effectiveness of different interventions. Overall, short-course regimens incorporating new drugs can improve treatment success rates and deliver favorable cost-effectiveness or direct cost savings in multiple national settings. Patient-centered innovative management models can also substantially reduce disease burden. Nevertheless, existing studies have limitations in coverage of special populations, comprehensiveness of cost perspectives, and integration of real-world data. Future research should strive to establish a more comprehensive, precise and translatable economic evaluation system, so as to facilitate the optimization of RR/MDR-TB prevention and treatment strategies and rational allocation of public health resources.

Key words: Drug resistance, Tuberculosis, Drug therapy, combination, Economics, medical, Review