Effect of Drug Cost-Exemption Policy on Treatment Outcomes in Multidrug-Resistant Tuberculosis Patients in Guangxi Zhuang Autonomous Region, China: A Nested Case–Control Study
Abstract
Background The most effective patient support interventions in low- and middle-income countries remain a research gap in World Health Organization consolidated guidelines on tuberculosis. We explored the impact of a partial drug cost-exemption policy (including cycloserine, moxifloxacin, linezolid, and clofazimine) implemented in Guangxi Zhuang Autonomous Region, China, on treatment outcomes among local multidrug-resistant tuberculosis (MDR-TB) patients. Methods This case–control study enrolled 424 MDR-TB patients receiving anti-TB treatment between 2020 and 2022 in Guangxi Zhuang Autonomous Region. Data on demographics, treatment regimen, drug cost-exemption status, and adverse reactions were extracted from electronic medical records. Multivariable logistic regression analysis was used to identify factors associated with successful treatment outcomes. Results Among the 424 enrolled MDR-TB patients, 212 (50.0%) had successful treatment outcomes, including 79 cured (18.6%) and 133 treatment completed (31.4%). Unfavorable outcomes were observed in 212 patients (50.0%), comprising 190 lost to follow-up (44.8%), 19 deaths (4.5%), and 3 treatment failures (0.7%). Multivariable analysis revealed that female sex (aOR = 2.99, 95% CI: 1.55–5.78), absence of adverse drug reactions (aOR = 11.58, 95% CI: 3.81–35.18), and receiving drug cost-exemption (aOR = 37.47, 95% CI: 10.97–127.96) were associated with favorable treatment outcomes. Furthermore, receiving an increasing number of…
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