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Costs (2016 US$) were estimated using an ingredient\u2019s approach from a healthcare provider perspective. The per\u2010patient and total cost of drug rechallenge, the current management strategy for severe CADR, was calculated. Alternative strategies involving second\u2010line treatment were derived from literature and expert clinical advice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Drug rechallenge costs US $5831 (95% CI: 5134\u20136527) per patient. Hospitalisation accounted for 62% of this cost. Alternative CADR management strategies using regimens containing rifabutin, bedaquiline and\/or delamanid cost 44%\u201355% less than drug rechallenge (US $2651\u2013US $3276\/patient). In univariate sensitivity analyses, drug rechallenge and alternative strategies were most sensitive to hospitalisation and tuberculosis drug costs, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Cutaneous adverse drug reactions to anti\u2010tuberculosis treatment represent a significant economic burden. An alternate strategy of outpatient\u2010initiated second\u2010line therapy is economically feasible but requires clinical validation to assess effectiveness.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.13275","type":"journal-article","created":{"date-parts":[[2019,6,7]],"date-time":"2019-06-07T14:48:12Z","timestamp":1559918892000},"page":"994-1002","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Cost of managing severe cutaneous adverse drug reactions to first\u2010line tuberculosis therapy in South Africa"],"prefix":"10.1111","volume":"24","author":[{"given":"Lauren K.","family":"Knight","sequence":"first","affiliation":[{"name":"Division of Dermatology, Department of Medicine University of Cape Town Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rannakoe J.","family":"Lehloenya","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Department of Medicine University of Cape Town Cape Town South Africa"},{"name":"Department of Medicine, Combined Drug Allergy Clinic University of Cape Town and Groote Schuur Hospital Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edina","family":"Sinanovic","sequence":"additional","affiliation":[{"name":"Health Economics Division, School of Public Health &amp; Family Medicine University of Cape Town Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anil","family":"Pooran","sequence":"additional","affiliation":[{"name":"Department of Medicine &amp; Lung Institute, Centre for Lung Infection and Immunity University of Cape Town Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,6,24]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"World Health Organisation.Media Centre Tuberculosis Fact Sheet 2016. 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