Cost Effective Analysis and role of Liv-52 and Ursodeoxycholic acid in Anti-Tubercular induced Hepatotoxicity: A Randomized Open Controlled Monocentric Study

Abstract

Abstract Background Anti-tubercular medications can cause hepatic degradation in patients on first-line therapy. However, the hepatoprotective medications used as an encounter therapy to protect the patients. Hepatoprotective drugs like Ursodeoxycholic acid (UDCA) and Liv-52 are proven safe and effective, the high cost of UDCA raises concerns for prescribing. This study aimed to compare UDCA's cost-effectiveness with Liv-52. Materials & Methods A randomized open-label controlled trial conducted at Rajendra Memorial Institute of Medical Sciences (RMRIMS), Patna. The study participants were recruited based on the inclusion criteria and were randomly divided into two groups, i.e., Group A (n = 28) and Group B (n = 27), where Liv-52 and UDCA drugs were prescribed. To compare the cost-effectiveness of this regimens LFT and cost related data were gathered from each patient, Incremental Cost Effective Ratio (ICER) was used to combine the results. SPSS v28 was used for final data analysis. Results A total of 80 patients were recruited initially, fifty seven patient data were included in the final analysis. The outcome measures included total bilirubin, alanine aminotransferase, aspartate aminotransferase, and alkaline Phosphatase. All the LFT clinical parameters are clinically significant but not statistically. But the Incremental cost-effectiveness ratio of Liv-52 and UDCA related to the change in Liver function test profile is statistically significant (p < 0.05) where UDCA is more costly than Liv-52. Conclusion The results demonstrated that the patients treated with Liv-52 and UDCA for 6 months had significantly better hepatoprotective activity and normal liver enzyme levels. We conclude that Liv-52 and UDCA possess hepatoprotective effects in tuberculosis patients, and when it related to cost effectiveness, Liv-52 is cheaper for the patients.