Stellenbosch University
Browse

Pharmaceutical cost dynamics for the treatment of rifampicin-resistant tuberculosis in children and adolescents in South Africa, India, and the Philippines

dataset
posted on 2025-04-25, 10:02 authored by Thomas Wilkinson, Anthony J Garcia-Prats, Tina Sachs, Mandar Paradkar, Nishi Suryavanshi, Aarti Kinikar, Melchor V. Frias, Edina Sinanovic, Anneke C. Hesseling, James A. Seddon, Megan Palmer

Rifampicin-resistant (RR) tuberculosis (TB) in children is a major global health concern but is often neglected in economics research. Accurate cost estimations across the spectrum of paediatric RR-TB treatment regimens are critical inputs for prioritisation and budgeting decisions, and an existing knowledge gap at local and international levels. This normative cost analysis was nested in a Phase I/II pharmacokinetics, safety, tolerability, and acceptability trial of TB medications in children in South Africa, the Philippines and India. It assessed the pharmaceutical costs of 36 childhood RR-TB regimens using combinations from 16 different medicines in 34 oral formulations (adult and child-friendly) in 11 weight bands in children <15 years of age. The analysis used local and Global Drug Facility pricing, and local and international guideline recommendations, including adaptions of BPaL and BPaLM regimens in adults. Costs varied significantly between regimen length, age/weight banding, severity of disease, presence of fluroquinolone resistance, and different country guideline recommendations. WHO recommended regimen costs ranged 12-fold: from US$232 per course (short regimen in non-severe disease) to US$2,761 (long regimen in severe, fluroquinolone-resistant disease). Regimen treating fluoroquinolone-resistant infection cost US$1,090 more than comparable WHO-recommended regimen. Providing child-friendly medicine formulations in <5-year-olds across all WHO-recommended regimens is expected to cost an additional $380 (range $212-$563) per child but is expected to have wider benefits including palatability, acceptability, adherence, tolerability, and dose accuracy. There were substantial differences in regimen affordability between countries when adjusted for purchasing power and domestic spending on health. Appropriate, effective, and affordable treatment options are an important component of the fight against childhood RR-TB. A comprehensive understanding of the cost and affordability dynamics of treatment options will enable national TB programs and global collaborations to make the best use of limited healthcare resources for the care of children with RR-TB.

Funding

Unitaid funding

History

Publisher

Stellenbosch University

Contributor

Wilkinson, T; Garcia-Prats, AJ; Sachs, T; Paradkar, M; Suryavanshi, N; Kinikar, A; Frias, MV; Sinanovic, E; Hesseling, AC; Seddon, JA; & Palmer, M.

Date

2024-07-23

Format

.pdf .docx .png .tiff .ppt

Language

en

Geographical Location

South Africa, India, & the Philippines

Academic Group

  • Medicine and Health Sciences

Recommended Citation

Wilkinson, T; Garcia-Prats, AJ; Sachs, T; Paradkar, M; Suryavanshi, N; Kinikar, A; Frias, MV; Sinanovic, E; Hesseling, AC; Seddon, JA; & Palmer, M. 2024. Pharmaceutical cost dynamics for the treatment of rifampicin-resistant tuberculosis in children and adolescents in South Africa, India, and the Philippines. Stellenbosch University. Dataset. DOI: https://doi.org/10.25413/sun.28869206

Sustainable Development Goals (SDGs)

  • Goal 3​: GOOD HEALTH & WELL-BEING
  • Goal 11:​ SUSTAINABLE CITIES & COMMUNITIES

Usage metrics

    Licence

    Exports

    RefWorks
    BibTeX
    Ref. manager
    Endnote
    DataCite
    NLM
    DC