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Cost-effectiveness of 3 months of weekly rifapentine and isoniazid compared with other standard treatment regimens for latent tuberculosis infection: a decision analysis study
- Source :
- Journal of Antimicrobial Chemotherapy. 74:218-227
- Publication Year :
- 2018
- Publisher :
- Oxford University Press (OUP), 2018.
-
Abstract
- Background: Latent tuberculosis infection (LTBI) is a critical driver of the global burden of active TB, and therefore LTBI treatment is key for TB elimination. Treatment regimens for LTBI include self-administered daily isoniazid for 6 (6H) or 9 (9H) months, self-administered daily rifampicin plus isoniazid for 3 months (3RH), self-administered daily rifampicin for 4 months (4R) and weekly rifapentine plus isoniazid for 3 months self-administered (3HP-SAT) or administered by a healthcare worker as directly observed therapy (3HP-DOT). Data on the relative cost-effectiveness of these regimens are needed to assist policymakers and clinicians in selecting an LTBI regimen. Objectives: To evaluate the cost-effectiveness of all regimens for treating LTBI. Methods: We developed a Markov model to investigate the cost-effectiveness of 3HP-DOT, 3HP-SAT, 4R, 3RH, 9H and 6H for LTBI treatment in a cohort of 10000 adults with LTBI. Cost-effectiveness was evaluated from a health system perspective over a 20 year time horizon. Results: Compared with no preventive treatment, 3HP-DOT, 3HP-SAT, 4R, 3RH, 9H and 6H prevented 496, 470, 442, 418, 370 and 276 additional cases of active TB per 10000 patients, respectively. All regimens reduced costs and increased QALYs compared with no preventive treatment. 3HP was more cost-effective under DOT than under SAT at a cost of US$27948 per QALY gained. Conclusions: Three months of weekly rifapentine plus isoniazid is more cost-effective than other regimens. Greater recognition of the benefits of short-course regimens can contribute to the scale-up of prevention and achieving the ‘End TB’ targets.
- Subjects :
- Adult
Male
0301 basic medicine
Microbiology (medical)
medicine.medical_specialty
Tuberculosis
Adolescent
Cost effectiveness
Cost-Benefit Analysis
030106 microbiology
Antitubercular Agents
Decision Support Techniques
Young Adult
03 medical and health sciences
0302 clinical medicine
Latent Tuberculosis
Internal medicine
Isoniazid
medicine
Humans
Pharmacology (medical)
030212 general & internal medicine
Aged
Pharmacology
Latent tuberculosis
business.industry
Standard treatment
Health Care Costs
Middle Aged
bacterial infections and mycoses
medicine.disease
Rifapentine
Quality-adjusted life year
Regimen
Infectious Diseases
Drug Therapy, Combination
Female
Rifampin
business
medicine.drug
Subjects
Details
- ISSN :
- 14602091 and 03057453
- Volume :
- 74
- Database :
- OpenAIRE
- Journal :
- Journal of Antimicrobial Chemotherapy
- Accession number :
- edsair.doi.dedup.....466ebbd464fdb043f3a6ece0d7163db6