LSTM study: new nine-month MDR-TB treatment regimen significantly reduces costs for patients and health systems compared to standard 20-24 month regimen

News article 17 Oct 2017

An health economics analysis, led by Liverpool School of Tropical Medicine (LSTM), has shown that the economic burden of multidrug-resistant tuberculosis (MDR-TB) reduces significantly when a nine month treatment regimen is being followed compared to the 20 to 24 month treatment regimen.

The analysis was done as part of the so-called STREAM trial, which preliminary results, including the outcomes of the health economics analysis, were presented during the 48th Union Conference on Lung Health in Mexico, earlier this month. In a response, the World Health Organization (WHO) welcomed the initial results of the trial.

'By analysing data from South Africa and Ethiopia, the costs to the health system for each patient were reduced by approximately a third when following the 9 month MDR TB treatment regimen', said LSTM's Professor Bertie Squire who, together with Dr Jason Madan from the University of Warwick's Medical School, presented the health economics analysis outcomes to the Conference. 'More importantly, the costs for patients themselves were also reduced due to fewer visits to health facilities, less spending on food whilst under shorter treatment and being able to get back to work sooner, even before completing the shorter treatment', Professor Squire added.

The collaboration between LSTM and University of Warwick Medical School for this work is part of the Collaboration for Applied Health Research & Delivery (CAHRD). With funding from USAID, routine health system costs from local sources and staff interviews from local health facilities were captured in both countries. In addition ‘serious adverse events' costs were measured. Patients costs, supporter costs and coping strategies were captured on a regular basis combined with more general socio-economic and income data.

Whilst data are still being analysed, initial indications point to cost savings for the respective health systems per patient of around USD 5,000 in South Africa and around USD 3,000 in Ethiopia.

These preliminary findings are part of the STREAM trial, which was initiated by the Union Against Tuberculosis and Lung Disease in 2012. STREAM is the world's first multi-country randomised clinical trial to test the efficacy, safety and economic impact of shortened multidrug-resistant (MRD-TB) treatment regimens.

Final findings are expected in April 2018.