From the 2022 South Africa paper, it appears that the bedaquiline-based regimen actually consists of 8 different drugs (see table S1), with a total cost per treatment of $6402 in the base-case. It’s not clear to me how much each drug contributes to the total cost, but you should be able to work this out from the regimen info from table S1 and the drug cost data from the medicines catalog (from reference 24 of the paper). Presumably if you’ve done it right you should end up with ~$6,402. Then you can just tweak the cost of bedaquiline (I’m assuming no other drugs have also changed price).
If you manage to do this, then quite plausibly your updated cost per treatment will fall within the range of the paper’s one-way sensitivity analysis ($5,122 to $7,682), i.e. Figure 2. From this you can eyeball what the new ICER will be:
Alternatively, you could try reaching out to the lead author—assuming they still have their model to hand, it should be very easy for them to adjust the cost of BDQ and see what the model outputs :)
Also, just to caution, the South Africa paper is “from the perspective of the South Africa national healthcare provider” and so uses the GDP per capita of South Africa as the willingness-to-pay threshold, and some of the health and cost data is also South Africa-specific. So I don’t think this can easily be used to infer the change in cost-effectiveness in other settings (though it might give a rough indication of whether or not there could be a substantial change).
Hey Spencer!
From the 2022 South Africa paper, it appears that the bedaquiline-based regimen actually consists of 8 different drugs (see table S1), with a total cost per treatment of $6402 in the base-case. It’s not clear to me how much each drug contributes to the total cost, but you should be able to work this out from the regimen info from table S1 and the drug cost data from the medicines catalog (from reference 24 of the paper). Presumably if you’ve done it right you should end up with ~$6,402. Then you can just tweak the cost of bedaquiline (I’m assuming no other drugs have also changed price).
If you manage to do this, then quite plausibly your updated cost per treatment will fall within the range of the paper’s one-way sensitivity analysis ($5,122 to $7,682), i.e. Figure 2. From this you can eyeball what the new ICER will be:
Alternatively, you could try reaching out to the lead author—assuming they still have their model to hand, it should be very easy for them to adjust the cost of BDQ and see what the model outputs :)
Also, just to caution, the South Africa paper is “from the perspective of the South Africa national healthcare provider” and so uses the GDP per capita of South Africa as the willingness-to-pay threshold, and some of the health and cost data is also South Africa-specific. So I don’t think this can easily be used to infer the change in cost-effectiveness in other settings (though it might give a rough indication of whether or not there could be a substantial change).