Catalysing tuberculosis elimination in Indonesia: Health economic and policy insights from the BPaL regimen

Abdullah Antaria, Heidy Agustina, Ratnawati Ratnawati, Sita Laksmi Andarini and Diah Handayani

PLOS ONE, 2026, vol. 21, issue 8, 1-13

Abstract: Background: Indonesia diagnoses roughly 24,000 multidrug-resistant tuberculosis (MDR-TB) cases each year, 8% of the world’s total. Conventional treatment runs 18–24 months, costs US$7,142–9,000 per patient, and succeeds in only 59% of cases. The WHO endorsed Bedaquiline-Pretomanid-Linezolid (BPaL) regimen has shown over 89% efficacy in controlled trials, but real-world health economic data from low- and middle-income countries remain scarce. Methods: We conducted a retrospective cohort study of 84 patients with MDR-TB, rifampicin-resistant TB (RR-TB), or pre-extensively drug-resistant TB (pre-XDR-TB) treated at Persahabatan Hospital, Jakarta, between 2021 and 2024. We compared treatment success, costs, and operational metrics against historical controls from 2018–2020. Statistical methods included chi-square tests, multivariate logistic regression, and incremental cost-effectiveness ratio (ICER) calculations, with sensitivity analyses across ±20% cost and ±10% efficacy ranges. Results: BPaL achieved 77.4% treatment success (65/84 patients) compared with 59% in historical controls (p

Date: 2026
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0351836

DOI: 10.1371/journal.pone.0351836

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