| Title: | Availability and costs of medicines for the treatment of tuberculosis in Europe |
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| Authors: | ID Günther, Gunar (Author)
ID Guglielmetti, Lorenzo (Author)
ID Leu, Claude (Author)
ID Lange, Christoph (Author)
ID Leth, Frank van (Author)
ID Svetina, Petra, Klinika Golnik (Research coworker) |
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| Files: |  URL - Source URL, visit https://www.clinicalmicrobiologyandinfection.com/action/showPdf?pii=S1198-743X%2822%2900394-9
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| Language: | English |
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| Typology: | 1.02 - Review Article |
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| Organization: |  UKPBAG - University Clinic of Respiratory and Allergic Diseases Golnik
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| Abstract: | Objectives. To evaluate the access to comprehensive diagnostics and novel anti-tuberculosis medicines in European countries. Methods. We investigated access to genotypic and phenotypic M. tuberculosis drug susceptibility testing, availability of anti-tuberculosis drugs and calculated cost of drugs and treatment regimens at major tuberculosis treatment centers in countries of the World Health Organization (WHO) European region where rates of drug-resistant tuberculosis are highest among all WHO regions. Results are stratified by middle-income and high-income countries. Results. Overall, 43 treatment centers in 43 countries participated in the study. For WHO Group A drugs, the frequency of countries with availability of phenotypic drug susceptibility testing was as follows: 30/40 (75%) for levofloxacin, 33/40 (82%) for moxifloxacin, 19/40 (48%) for bedaquiline and 29/40 (72%) for linezolid, respectively. Overall, 36/43 (84%) and 24/43 (56%) of countries had access to bedaquiline and delamanid, while only 6/43 (14%) had access to rifapentine. Treatment of patients with extensively drug-resistant tuberculosis with a regimen including a carbapenem was only available in 17/43 (40%) of the countries. Median cost of regimens for drug-susceptible tuberculosis, multidrug-resistant/rifampicin-resistant tuberculosis (shorter regimen, including bedaquiline for six months) and extensively drug-resistant tuberculosis (including bedaquiline, delamanid and a carbapenem) were € 44 (min-max € 15-152), € 764 (min-max € 542-15152) and € 8709 (min-max € 7965-11759) in middle-income countries (n=12), and € 280 (min-max-€78-1084), € 29765 (min-max 11116-40584), € 217591 (min-max € 82827-320146) in high-income countries (n=29). Conclusion. In countries of the WHO Europe Region there is a widespread lack of drug susceptibility testing capacity to new and re-purposed anti-tuberculosis drugs, lack of access to essential medications in several countries and high treatment cost for drug-resistant tuberculosis. |
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| Keywords: | tuberculosis - drug therapy, Mycobacterium tuberculosis - drug therapy, health care costs - drug therapy, Europe |
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| Article acceptance date: | 28.07.2022 |
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| Publication date: | 09.08.2022 |
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| Place of publishing: | Velika Britanija |
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| Publisher: | Elsevier |
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| Year of publishing: | 2022 |
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| Number of pages: | str. 1-29 |
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| Numbering: | Vol. 28, št. |
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| PID: | 20.500.12556/DiRROS-15410  |
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| UDC: | 616-002 |
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| ISSN on article: | 1469-0691 |
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| DOI: | 10.1016/j.cmi.2022.07.026 |
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| COBISS.SI-ID: | 119066371 |
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| Copyright: | © 2022 The Author(s). |
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| Note: | Nasl. z nasl. zaslona;
Članica raziskovalne skupine TBNET iz Slovenije: Petra Svetina;
Opis vira z dne 24. 8. 2022;
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| Publication date in DiRROS: | 31.08.2022 |
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| Views: | 1086 |
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| Downloads: | 282 |
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