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Cost-effectiveness of a 12-dose regimen for treating latent tuberculous infection in the United States.
Int J Tuberc Lung Dis. 2013 Dec; 17(12):1531-7.IJ

Abstract

SETTING

A large randomized controlled trial recently showed that for treating latent tuberculous infection (LTBI) in persons at high risk of progression to tuberculosis (TB) disease, a 12-dose regimen of weekly rifapentine plus isoniazid (3HP) administered as directly observed treatment (DOT) can be as effective as 9 months of daily self-administered isoniazid (9H).

OBJECTIVES

To assess the cost-effectiveness of 3HP compared to 9H.

DESIGN

A computational model was designed to simulate individuals with LTBI treated with 9H or 3HP. Costs and health outcomes were estimated to determine the incremental costs per active TB case prevented and per quality-adjusted life year (QALY) gained by 3HP compared to 9H.

RESULTS

Over a 20-year period, treatment of LTBI with 3HP rather than 9H resulted in 5.2 fewer cases of TB and 25 fewer lost QALYs per 1000 individuals treated. From the health system and societal perspectives, 3HP would cost respectively US$21,525 and $4294 more per TB case prevented, and respectively $4565 and $911 more per QALY gained.

CONCLUSIONS

3HP may be a cost-effective alternative to 9H, particularly if the cost of rifapentine decreases, the effectiveness of 3HP can be maintained without DOT, and 3HP treatment is limited to those with a high risk of progression to TB disease.

Authors+Show Affiliations

Division of Tuberculosis Elimination, National Center for HIV/AIDS, Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA; Steven M Teutsch Prevention Effectiveness Fellowship Program, Office of Surveillance, Epidemiology and Laboratory Sciences, CDC, Atlanta, Georgia, USA; Department of Mathematics and Statistics, Mount Holyoke College, South Hadley, Massachusetts, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

24200264

Citation

Shepardson, D, et al. "Cost-effectiveness of a 12-dose Regimen for Treating Latent Tuberculous Infection in the United States." The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease, vol. 17, no. 12, 2013, pp. 1531-7.
Shepardson D, Marks SM, Chesson H, et al. Cost-effectiveness of a 12-dose regimen for treating latent tuberculous infection in the United States. Int J Tuberc Lung Dis. 2013;17(12):1531-7.
Shepardson, D., Marks, S. M., Chesson, H., Kerrigan, A., Holland, D. P., Scott, N., Tian, X., Borisov, A. S., Shang, N., Heilig, C. M., Sterling, T. R., Villarino, M. E., & Mac Kenzie, W. R. (2013). Cost-effectiveness of a 12-dose regimen for treating latent tuberculous infection in the United States. The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease, 17(12), 1531-7. https://doi.org/10.5588/ijtld.13.0423
Shepardson D, et al. Cost-effectiveness of a 12-dose Regimen for Treating Latent Tuberculous Infection in the United States. Int J Tuberc Lung Dis. 2013;17(12):1531-7. PubMed PMID: 24200264.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cost-effectiveness of a 12-dose regimen for treating latent tuberculous infection in the United States. AU - Shepardson,D, AU - Marks,S M, AU - Chesson,H, AU - Kerrigan,A, AU - Holland,D P, AU - Scott,N, AU - Tian,X, AU - Borisov,A S, AU - Shang,N, AU - Heilig,C M, AU - Sterling,T R, AU - Villarino,M E, AU - Mac Kenzie,W R, PY - 2013/11/9/entrez PY - 2013/11/10/pubmed PY - 2014/6/26/medline SP - 1531 EP - 7 JF - The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease JO - Int J Tuberc Lung Dis VL - 17 IS - 12 N2 - SETTING: A large randomized controlled trial recently showed that for treating latent tuberculous infection (LTBI) in persons at high risk of progression to tuberculosis (TB) disease, a 12-dose regimen of weekly rifapentine plus isoniazid (3HP) administered as directly observed treatment (DOT) can be as effective as 9 months of daily self-administered isoniazid (9H). OBJECTIVES: To assess the cost-effectiveness of 3HP compared to 9H. DESIGN: A computational model was designed to simulate individuals with LTBI treated with 9H or 3HP. Costs and health outcomes were estimated to determine the incremental costs per active TB case prevented and per quality-adjusted life year (QALY) gained by 3HP compared to 9H. RESULTS: Over a 20-year period, treatment of LTBI with 3HP rather than 9H resulted in 5.2 fewer cases of TB and 25 fewer lost QALYs per 1000 individuals treated. From the health system and societal perspectives, 3HP would cost respectively US$21,525 and $4294 more per TB case prevented, and respectively $4565 and $911 more per QALY gained. CONCLUSIONS: 3HP may be a cost-effective alternative to 9H, particularly if the cost of rifapentine decreases, the effectiveness of 3HP can be maintained without DOT, and 3HP treatment is limited to those with a high risk of progression to TB disease. SN - 1815-7920 UR - https://www.unboundmedicine.com/medline/citation/24200264/Cost_effectiveness_of_a_12_dose_regimen_for_treating_latent_tuberculous_infection_in_the_United_States_ L2 - https://www.ingentaconnect.com/openurl?genre=article&issn=1815-7920&volume=17&issue=12&spage=1531&aulast=Shepardson DB - PRIME DP - Unbound Medicine ER -