Comparative Cost Analysis of Bedaquiline and Linezolid-Based Regimens for MDR/XDR-TB in India: A Public vs. Private Sector Perspective
Author(s)
Dhanshika Vijayabaskar, PharmD1, Balaji Thiyagarajan, Pharm D2, Madhumitha Balaji, Pharm D3, Shailaja Krishnamoorthy, Ph.D4.
1Student, C.L.Baid Metha College of Pharmacy, Chennai, India, 2c.l.baid metha college of pharmacy, Chennai, India, 3C.L.Baid Metha College of Pharmacy, Chennai, India, 4The Tamil Nadu Dr. M.G.R. Medical University, chennai, India.
1Student, C.L.Baid Metha College of Pharmacy, Chennai, India, 2c.l.baid metha college of pharmacy, Chennai, India, 3C.L.Baid Metha College of Pharmacy, Chennai, India, 4The Tamil Nadu Dr. M.G.R. Medical University, chennai, India.
OBJECTIVES: This study aims to assess the cost differences between Bedaquiline and Linezolid treatment regimens for multi-drug resistant and extensively drug-resistant and extensively drug-resistant tuberculosis (MDR/XDR-TB) in India, with an emphasis on the procurement and accessibility variations between the public sector (e.g., NTEP and Jan Aushadhi) and the private sector (e.g., 1mg and retail pharmacies)
METHODS: A cross-sectional pricing was undertaken using cost information from public procurement sources (NTEP, Global Drug Facility), Jan Aushadhi pricing lists, and private pharmacy platforms like 1mg.The estimated per-patient costs for a 6-month treatment course for MDR-TB were calculated for both medications. The analysis considered government-subsidized prices, the availability of generics, and the overall costs of the treatment regimen, inclusive of duration, dosage, and any necessary co-medications.
RESULTS: Bedaquiline was unavailable at Jan Aushadhi outlets, priced between ₹4,500 and ₹5,000 for a 6-month course on 1mg.Government-procured Bedaquiline was accessible at around ₹15,000 to ₹18,000 per course. Linezolid, found both at Jan Aushadhi (₹50 to ₹70 for a pack of 10 tablets) and in private pharmacies (₹150 to ₹250 for 10 tablets), indicated higher out-of-pocket expenses in the private sector. The total cost of a 6-month Linezolid regimen was estimated at ₹6,000 to ₹12,000 through Jan Aushadhi, compared to ₹20,000 to ₹30,000 in private market. For combined regimens (Bedquiline+Linezolid) via NTEP, costs ranged from ₹80,000 to ₹100,000 per patient, whereas private access might surpass ₹120,000.
CONCLUSIONS: The procurement process in the public sector significantly alleviates the financial burden associated with MDR/XDR-TB treatment. While Linezolid is obtainable at Jan Aushadhi, Bedquiline continues to be primarily available through government programs. Enhancing coordination between public and private sectors and broadening access to affordable treatment-especially for Bedaquiline-are critical for achieving equitable management of MDR/XDR in India.
METHODS: A cross-sectional pricing was undertaken using cost information from public procurement sources (NTEP, Global Drug Facility), Jan Aushadhi pricing lists, and private pharmacy platforms like 1mg.The estimated per-patient costs for a 6-month treatment course for MDR-TB were calculated for both medications. The analysis considered government-subsidized prices, the availability of generics, and the overall costs of the treatment regimen, inclusive of duration, dosage, and any necessary co-medications.
RESULTS: Bedaquiline was unavailable at Jan Aushadhi outlets, priced between ₹4,500 and ₹5,000 for a 6-month course on 1mg.Government-procured Bedaquiline was accessible at around ₹15,000 to ₹18,000 per course. Linezolid, found both at Jan Aushadhi (₹50 to ₹70 for a pack of 10 tablets) and in private pharmacies (₹150 to ₹250 for 10 tablets), indicated higher out-of-pocket expenses in the private sector. The total cost of a 6-month Linezolid regimen was estimated at ₹6,000 to ₹12,000 through Jan Aushadhi, compared to ₹20,000 to ₹30,000 in private market. For combined regimens (Bedquiline+Linezolid) via NTEP, costs ranged from ₹80,000 to ₹100,000 per patient, whereas private access might surpass ₹120,000.
CONCLUSIONS: The procurement process in the public sector significantly alleviates the financial burden associated with MDR/XDR-TB treatment. While Linezolid is obtainable at Jan Aushadhi, Bedquiline continues to be primarily available through government programs. Enhancing coordination between public and private sectors and broadening access to affordable treatment-especially for Bedaquiline-are critical for achieving equitable management of MDR/XDR in India.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE137
Topic
Economic Evaluation, Epidemiology & Public Health
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)