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Submitted: 16 August 2011 Modified: 11 May 2018
HERDIN Record #: PCHRD08161110085899

Cost benefit analysis of triple versus quadruple regimens in the short course daily chemotherapy for pulmonary tuberculosis.

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OBJECTIVES:


The project aimed to improve the health care delivery in government hospital through the identification of more efficient health care management tools. Specifically the study sought to: (1) evaluate the efficacy of the short course standard daily triple and quadruple drug regimens for patients with sputum-positive pulmonary tuberculosis as reported in published randomized controlled trials; (2) review data on drug resistance of the tubercle bacilli in the Philippines; (3) determine the clinical experience of physicians who are using standard triple-drug regimen for pulmonary tuberculosis through a mail survey; (4) analyze which therapeutic regimen is more cost-beneficial and (5) make a sensitivity analysis to find out at what relapse and treatment failure rates quadruple-drug regimen is cheaper than triple-drug regimen.


ABSTRACT:


A literature review of foreign and local randomized controlled trials for six month daily chemotherapy for pulmonary tuberculosis was done to compare which treatment program, is more cost-effective, the standard triple-drug regimen or the quadruple-drug regimen. The study included a review of the local studies for drug resistance against anti-TB drugs. Likewise, a mail survey was made to determine the actual clinical experience of physicians all over the country on the effectiveness of the triple-drug regimen for pulmonary tuberculosis. Computations made based on the literature review showed the total program cost for treating 100 patients for the four-drug regimen is higher by P14,934 compared to the triple-drug regimen. This can be explained by the higher efficacy of the quadruple regimen. However, local studies have noted the higher incidence of drug-resistance to anti-tuberculosis drugs including ethambutol. The result of the survey, which had 237 respondents, suggested that a small percentage (38.9%) of physicians believe that the standard regimen is less effective with 38 of them (42.4%) attributing this to drug resistance. The threshold analysis disclosed that program cost for treating tuberculosis cases can be altered by different relapse and treatment failure rates. There is a need to determine the actual relapse and treatment failure rates in the local setting to be able to make an accurate cost-effectiveness analysis. The recommendation to make a quadruple-drug regimen to all Filipinos with pulmonary tuberculosis should be studied more closely so that the most effective and economic use of these drugs can be attained.

Publication Type
Research Project
Date
November 30, 1989-November 30, 1990
LocationLocation CodeAvailable FormatAvailability
Philippine Council for Health Research and Development Library Abstract Print Format (Request Document)