Cost-Effectiveness of Tuberculous Meningitis Treatment Novi V. Utami (a*), Adiatma Y. M. Siregar (b), Auliya A. Suwantika (c), Rovina Ruslami (a)
(a) Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, Indonesia
*novi.utami[at]unpad.ac.id
(b) Faculty of Economics Universitas Padjadjaran, Bandung, West Java, Indonesia
(c) Faculty of Pharmacy Universitas Padjadjaran, Bandung, West Java, Indonesia
Abstract
Tuberculous meningitis is a form of tuberculous infection with high mortality and morbidity. Many studies were conducted to search for new options in its therapy. Intensified regimen therapy is considered to replace the standard regimen therapy. This study aimed to analyze the cost-effectiveness of tuberculous meningitis treatment by considering intensified regimen therapy. We conducted a retrospective study by assessing the costs of tuberculous meningitis treatment in previous clinical trial (Redefine Study). The earlier study was registered in ClinicalTrials.gov (NCT02169882). We calculated the costs of treatment of two groups of patients: the intensified regimen therapy group (with rifampicin 30mg/kg body weight) and the standard regimen therapy group (with rifampicin 10mg/kg body weight). The costs were calculated based on the case report form (trial record) information, using a social perspective. The incremental cost-effectiveness ratio (ICER) was calculated using the number of deaths as the clinical parameter. In addition, the cost due to premature death was also calculated. The total costs of tuberculous meningitis treatment in each group are IDR 544,925,227 (USD 35,764) in the standard group and IDR 673,985,857 (USD 44,234) in the intensified group. The ICER is IDR 32,265,158 (USD 2118) per death averted. Considering mortality cost, the cost due to premature death is IDR 555,523,650 (USD 39,700) per patient in the standard group and IDR 604,903,530 (USD 36,459) per patient in the intensified group. In conclusion, shifting from the standard into intensified regimen therapy in tuberculous meningitis treatment would cost IDR 32,265,158 (USD 2118) per death averted.
