title: Cost-effectiveness of Bedaquiline for the Treatment of Multidrug-resistant Tuberculosis in the Republic of Korea.
abstract: OBJECTIVE
  Bedaquiline is a new drug used for the treatment of multidrug-resistant tuberculosis (MDR-TB). This study aimed to evaluate the cost-effectiveness of adding bedaquiline to a standard regimen (SR) for treating patients with MDR-TB, including extensively drug-resistant (XDR)-TB, in the Republic of Korea.
  
  
  METHODS
  A cohort-based decision-analytic model developed in a previously published study from the United Kingdom was used, with a 20-year time horizon and a 5% discount rate for cost and effectiveness, to evaluate the incremental cost-effectiveness ratios of bedaquiline + SR and SR only. The key parameters regarding the clinical data were available via the published Phase II trial of bedaquiline. Additional parameters for recurrence, cure status, loss to follow-up, surgery, death, cost, and health utility were based on Korean data if available; otherwise the international literature data were applied. Univariate and probabilistic sensitivity analyses were conducted.
  
  
  RESULTS
  Based on the analysis, a patient on bedaquiline + SR would gain 1.20 quality-adjusted life-years (QALYs) at 13,961,659 Korean won (KRW) (1100 KRW = US $1) of additional cost compared with a patient administered SR only, with an incremental cost/utility ratio of 11,638,656 KRW/QALY. Bedaquiline + SR had an 80% probability of being cost-effective, at a willingness-to-pay threshold of 26 million KRW, compared with SR only.
  
  
  CONCLUSIONS
  The results of this study suggest that, in the Republic of Korea, bedaquiline, as a part of combination therapy with SR, is a cost-effective option for the treatment of MDR-TB (including XDR-TB) compared with SR only.
authors.affiliation: College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Buk-gu Daegu, Republic of Korea.
authors.forename: Hae-Young
authors.initials: HY
authors.lastname: Park
authors.affiliation: School of Pharmacy, Sungkyunkwan University, Kyunggi, Republic of Korea.
authors.forename: Hye-min
authors.initials: HM
authors.lastname: Ku
authors.affiliation: Graduate School of Clinical Pharmacy, CHA University, Gyeonggi-do, Republic of Korea.
authors.forename: Hyun-Soon
authors.initials: HS
authors.lastname: Sohn
authors.affiliation: Department of Tuberculosis, Seoul Metropolitan Seobuk Hospital, Seoul, Republic of Korea.
authors.forename: Hae-Sook
authors.initials: HS
authors.lastname: Seo
authors.affiliation: Janssen Korea Ltd, Seoul, Republic of Korea.
authors.forename: Hyun
authors.initials: H
authors.lastname: Yung Lee
authors.affiliation: Janssen Korea Ltd, Seoul, Republic of Korea.
authors.forename: Kyung
authors.initials: K
authors.lastname: Hwa Lim
authors.affiliation: College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Buk-gu Daegu, Republic of Korea. Electronic address: jwkwon@knu.ac.kr.
authors.forename: Jin-Won
authors.initials: JW
authors.lastname: Kwon
mesh_terms: D003362:Cost-Benefit Analysis; D064687:Diarylquinolines / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D019057:Quality-Adjusted Life Years; D056910:Republic of Korea; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy* / Q000191:economics
chemical_list: D064687:Diarylquinolines; C493870:bedaquiline
keywords: bedaquiline; cost-effectiveness; multidrug-resistant tuberculosis