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Impact and cost-effectiveness of the 6-month BPaLM regimen for rifampicin-resistant tuberculosis in Moldova: A mathematical modeling analysis

Author summary Why was this study done? Drug resistance poses a major barrier to the effective treatment of tuberculosis, especially in Moldova and other post-Soviet states which have the highest levels of resistance in the world. Individuals with tuberculosis resistant to the key drug rifampicin face a worse prognosis, a longer and more expensive course of treatment, and more side effects than individuals with rifampicin-susceptible tuberculosis. Until recently, the standard of care for rifampicin-resistant tuberculosis (RR-TB) involved many drugs in combination, often given for 18 months or longer. The newer, 6-month “BPaLM” regimen is comprised of 4 drugs (bedaquiline, pretomanid, linezolid, and moxifloxacin) to which resistance levels are currently low, and while it was shown to be just as effective as the standard of care when health outcomes were measured at 72 weeks from treatment initiation, its effect on lifetime health outcomes, costs, and the acquisition of dru

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