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Cost-effectiveness of Preventive Therapy for Tuberculosis With Isoniazid and Rifapentine Versus Isoniazid Alone in High-Burden Settings
DC Field | Value | Language |
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dc.contributor.author | Johnson, Karl T. | - |
dc.contributor.author | Churchyard, Gavin J. | - |
dc.contributor.author | Sohn, Hojoon | - |
dc.contributor.author | Dowdy, David W. | - |
dc.date.accessioned | 2024-05-14T04:35:08Z | - |
dc.date.available | 2024-05-14T04:35:08Z | - |
dc.date.created | 2024-05-14 | - |
dc.date.issued | 2018-10 | - |
dc.identifier.citation | CLINICAL INFECTIOUS DISEASES, Vol.67 No.7, pp.1072-1078 | - |
dc.identifier.issn | 1058-4838 | - |
dc.identifier.uri | https://hdl.handle.net/10371/201761 | - |
dc.description.abstract | Background. A short-course regimen of 3 months of weekly rifapentine and isoniazid (3HP) has recently been recommended by the World Health Organization as an alternative to at least 6 months of daily isoniazid (isoniazid preventive therapy [IPT]) for prevention of tuberculosis (TB). The contexts in which 3HP may be cost-effective compared to IPT among people living with human immunodeficiency virus are unknown. Methods. We used a Markov state transition model to estimate the incremental cost-effectiveness of 3HP relative to IPT in high-burden settings, using a cohort of 1000 patients in a Ugandan HIV clinic as an emblematic scenario. Cost-effectiveness was expressed as 2017 US dollars per disability-adjusted life year (DALY) averted from a healthcare perspective over a 20-year time horizon. We explored the conditions under which 3HP would be considered cost-effective relative to IPT. Results. Per 1000 individuals on antiretroviral therapy in the reference scenario, treatment with 3HP rather than IPT was estimated to avert 9 cases of TB and 1 death, costing $9402 per DALY averted relative to IPT. Cost-effectiveness depended strongly on the price of rifapentine, completion of 3HP, and prevalence of latent TB. At a willingness to pay of $1000 per DALY averted, 3HP is likely to be cost-effective relative to IPT only if the price of rifapentine can be greatly reduced (to approximately $20 per course) and high treatment completion (85%) can be achieved. Conclusions. 3HP may be a cost-effective alternative to IPT in high-burden settings, but cost-effectiveness depends on the price of rifapentine, achievable completion rates, and local willingness to pay. | - |
dc.language | 영어 | - |
dc.publisher | OXFORD UNIV PRESS INC | - |
dc.title | Cost-effectiveness of Preventive Therapy for Tuberculosis With Isoniazid and Rifapentine Versus Isoniazid Alone in High-Burden Settings | - |
dc.type | Article | - |
dc.identifier.doi | 10.1093/cid/ciy230 | - |
dc.citation.journaltitle | CLINICAL INFECTIOUS DISEASES | - |
dc.identifier.wosid | 000445387500012 | - |
dc.identifier.scopusid | 2-s2.0-85053863157 | - |
dc.citation.endpage | 1078 | - |
dc.citation.number | 7 | - |
dc.citation.startpage | 1072 | - |
dc.citation.volume | 67 | - |
dc.description.isOpenAccess | Y | - |
dc.contributor.affiliatedAuthor | Sohn, Hojoon | - |
dc.type.docType | Article | - |
dc.description.journalClass | 1 | - |
dc.subject.keywordPlus | HIV-INFECTED PATIENTS | - |
dc.subject.keywordPlus | ANTIRETROVIRAL THERAPY | - |
dc.subject.keywordPlus | REGIMENS | - |
dc.subject.keywordPlus | AFRICA | - |
dc.subject.keywordPlus | COHORT | - |
dc.subject.keywordAuthor | cost-effectiveness analysis | - |
dc.subject.keywordAuthor | latent tuberculosis | - |
dc.subject.keywordAuthor | HIV infections | - |
dc.subject.keywordAuthor | isoniazid | - |
dc.subject.keywordAuthor | rifapentine | - |
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