farmaecFARMAKOEKONOMIKA. Modern Pharmacoeconomics and PharmacoepidemiologyФАРМАКОЭКОНОМИКА. Современная фармакоэкономика и фармакоэпидемиология2070-49092070-4933IRBIS LLC10.17749/2070-4909/farmakoekonomika.2022.131farmaec-714Research ArticleREVIEW ARTICLESОБЗОРНЫЕ ПУБЛИКАЦИИEconomic aspects of using new chemotherapy regimens for multidrug and extensively drugresistant tuberculosisЭкономические аспекты применения новых режимов химиотерапии туберкулеза с множественной и широкой лекарственной устойчивостьюhttps://orcid.org/0000-0003-3383-7723КукурикаА. В.KukurikaА. V.

Кукурика Анастасия Владимировна – врач-фтизиатр. РИНЦ SPIN-код: 7973-8162.

Ул. Шопена, д. 1а, Макеевка 86112, Донецкая Народная Республика

Anastasia V. Kukurika – Phthisiologist, RSCI SPIN-code: 7973-8162.

1а Shopin Str., Makeyevka 86112, Donetsk People's Republic

nastya_kukurika@mail.ruГородской противотуберкулезный диспансер г. Макеевки Министерства здравоохранения Донецкой Народной РеспубликиРоссияMakeyevka City Tuberculosis DispensaryRussian Federation202209102022153353362Copyright © Kukurika А.V., 20222022Кукурика А.В.Kukurika А.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.pharmacoeconomics.ru/jour/article/view/714Objective

Objective: to systematize data on cost-effectiveness evaluation of new multidrug and extensively drug-resistant tuberculosis (MDR/XDR-TB) chemotherapy regimens.

Material and methods

Material and methods. An analysis of 19 publications devoted to the economic evaluation of the treatment of active MDR/XDR-TB was carried out. The literature search was performed in the electronic databases PubMed/MEDLINE, Google Scholar, eLibrary for the period from January 2015 to February 2022 inclusively.

Results

Results. Economic efficiency was studied in high-, middleand low-income countries. All publications contained calculation of treatment costs, and a third of the studies also estimated additional costs. Bedaquiline, delamanid, and pretomanid regimens were included in treatment alone or compared with a background regimen. The most commonly used economic model was the Markov one. To compare primary outcomes, most studies assessed disabilityand quality-adjusted life years. The overall cost of MDR/XDR-TB treatment varied by country income level. In all cases, bedaquiline-based regimens represented a cost-effective alternative to previous treatment, showed high efficacy in MDR/XDR-TB therapy, and were more cost-effective than delamanid regimens.

Conclusion

Conclusion. Cost-effective interventions for active MDR/XDR-TB therapy should include the introduction of new chemotherapy regimens, reduced hospital stays and decentralized treatment, which is especially relevant in countries with high tuberculosis burden.

Цель

Цель: систематизация данных, посвященных оценке экономической эффективности новых режимов химиотерапии туберкулеза с множественной и широкой лекарственной устойчивостью (МЛУ/ШЛУ-ТБ).

Материал и методы

Материал и методы. Поведен анализ 19 публикаций, посвященных экономической оценке лечения активного МЛУ/ШЛУ-ТБ. Поиск литературы осуществлялся в электронных базах данных PubMed/MEDLINE, Google Scholar, eLibrary за период с января 2015 г. по февраль 2022 г. включительно.

Результаты

Результаты. Экономическая эффективность исследована в странах с высоким, средним и низким уровнями дохода. Все работы содержали расчет затрат на лечение, треть исследований оценивали также дополнительные затраты. В терапию были включены схемы с бедаквилином, деламанидом, претоманидом, которые применялись изолированно или сравнивались с фоновым режимом. Наиболее часто использовалась марковская экономическая модель. Для сравнения первичных исходов в большинстве работ оценивались годы жизни с поправкой на инвалидность и качество жизни. Полная стоимость лечения МЛУ/ШЛУ-ТБ различалась в зависимости от уровня дохода стран. Во всех случаях схемы на основе бедаквилина представляли экономичную альтернативу предшествующему лечению, показывали высокую эффективность терапии МЛУ/ШЛУ-ТБ, были рентабельнее схем с деламанидом.

Заключение

Заключение. Экономически эффективными мероприятиями, направленными на лечение активного МЛУ/ШЛУ-ТБ, являются внедрение новых режимов химиотерапии, сокращение сроков госпитализации и децентрализованное лечение, что особенно актуально в странах с высоким бременем туберкулеза.

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The authors declare that there are no conflicts of interest present.