Cost-Effectiveness of Treating Multidrug-Resistant Tuberculosis
Author Information
Author(s): Stephen C Resch, Joshua A Salomon, Megan Murray, Milton C Weinstein
Primary Institution: Harvard School of Public Health, Harvard University
Hypothesis
Can standardized or individualized second-line regimens for MDR TB be cost-effective in lower-middle-income countries?
Conclusion
Treatment of MDR TB using second-line drugs is highly cost-effective in Peru.
Supporting Evidence
- Standardized second-line treatment for confirmed MDR TB cases had an incremental cost-effectiveness ratio of $720 per QALY.
- Individualized second-line drug treatment for MDR TB following first-line failure provided more benefit at an incremental cost of $990 per QALY.
- A more aggressive individualized treatment strategy had an incremental cost-effectiveness ratio of $11,000 per QALY.
Takeaway
This study shows that using better treatments for drug-resistant tuberculosis can save lives and is worth the money in places like Peru.
Methodology
A dynamic state-transition model was developed to evaluate the cost-effectiveness of five alternative treatment strategies for TB over a 30-year period.
Limitations
The analysis reflects the perspective of a public health-care system and does not include costs for patient time, transportation, and unpaid caregiver time.
Participant Demographics
The study focused on a lower-middle-income setting, specifically Peru, where 4.5% of TB cases are MDR TB.
Digital Object Identifier (DOI)
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