Cost-utility analysis of high-dose treatment for intermediate-susceptible, dose-dependent tuberculosis patientsZuur, M. A., van Asselt, A. D. I., van 't Boveneind-Vrubleuskaya, N., Aleksa, A., Postma, M. J. & Alffenaar, J. W. C., 1-Sep-2018, In : International Journal of Tuberculosis and Lung Disease. 22, 9, p. 991-999 10 p.
Research output: Contribution to journal › Article › Academic › peer-review
SETTING: We proposed to: 1) introduce an intermediate-susceptible, dose-dependent (ISDD) category for Mycobacterium tuberculosis infection; and 2) treat patients with M. tuberculosis infection in this category with a high dose of rifampicin (RMP) and isoniazid (INH).
OBJECTIVE : To examine the impact of our strategy on quality-adjusted life-years (QALY) and costs in a low-income country with a high prevalence of multidrug-resistant tuberculosis (MDR-TB) (Belarus) and a high-income, low MDR-TB prevalence country (The Netherlands).
DESIGN: A Markov model comprising 14 health states was used to simulate treatment outcomes and costs accrued over 5 years for a hypothetical cohort of 10 000 patients. One-way sensitivity analysis, probabilistic sensitivity analysis and a scenario analysis were also performed.
RESULTS : Our strategy was shown to be cost-effective for Belarus, but not for the Netherlands. At a willingness-to-pay of 50 000 euros per QALY, the probability of our strategy being cost-effective was 50% for the Netherlands and 57% for Belarus.
CONCLUSION: The study shows that our strategy could be cost-effective and more efficacious. However, more studies are needed on the outcomes of using higher doses of INH and RMP.
|Number of pages||10|
|Journal||International Journal of Tuberculosis and Lung Disease|
|Publication status||Published - 1-Sep-2018|
- cost-effectiveness, first-line anti-tuberculosis treatment, susceptibility testing, high-dose INH and RMP, MULTIDRUG-RESISTANT TUBERCULOSIS, RANDOMIZED CONTROLLED-TRIAL, MYCOBACTERIUM-TUBERCULOSIS, ANTITUBERCULOSIS DRUGS, PULMONARY TUBERCULOSIS, BREAKPOINTS, RIFAMPIN, THERAPY, OPTIMIZE, OUTCOMES