OBJECTIVES Prioritisation of oral bedaquiline over the injectable agents in the treatment of multidrug-resistant Tuberculosis (MDR-TB) in the World Health Organisations (WHO) 2019 guidelines prompted this UK analysis of cost implications. The objective was to estimate the costs of amikacin versus bedaquiline in MDR TB treatment regimens using a historical cohort where the injectable agents were the standard of care. METHODS This was a retrospective study using a known cohort of UK patients treated with an injectable agent, with data available on resource use, costs for the use of amikacin were compared with those for bedaquiline, based on recommended monitoring for bedaquiline. RESULTS The estimated cost of treatment per patient had mean (sd) of £27,236 (4952) for the observed injectable group, £30,264 (3392) and 36,309 (3901) for the 6 and 8 month amikacin groups, and £31,760 (2092) for the bedaquiline group. The cost in the bedaquiline group was £30,772 (1855) with a 10% reduction and £27,079 (1234) with a 33% reduction in-patient stay. CONCLUSIONS In most scenarios, bedaquiline is close to cost neutral compared with injectable therapy, especially if, as expected, some reduction in duration of admission is possible as a result of bedaquiline's more rapid culture conversion.

中文翻译：

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在英国，丁胺卡那霉素与苯达喹啉治疗耐药结核病的成本比较。

目标根据世界卫生组织（WHO）2019指南，在治疗耐多药结核病（MDR-TB）中优先使用口服苯达喹啉优先于注射剂，这促使英国进行了成本影响分析。目的是使用可注射药物作为护理标准的历史队列来评估阿米卡星与苯达喹啉在耐多药结核病治疗方案中的费用。方法这是一项回顾性研究，使用英国已知的接受注射剂治疗的患者队列，并获得了资源使用方面的数据，根据推荐的苯达喹啉监测，将丁胺卡那霉素的使用费用与苯达喹啉的费用进行了比较。结果对于观察到的注射组，每位患者的估计治疗成本平均（sd）为27,236英镑（4952），30,264英镑（3392）和36，六个月和八个月的丁胺卡那霉素组为309（3901），而苯达喹啉组为31,760（2092）。苯达喹啉组的费用为30,772英镑（1855年），减少了10％；费用为27,079英镑（1234），减少了33％的住院时间。结论在大多数情况下，与注射疗法相比，贝达喹啉接近于成本中性，特别是如果如预期的那样，由于苯达喹啉更快地进行了培养转化，住院时间可能会有所减少。