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-Sept-2018|
- first-line anti-tuberculosis treatment
- susceptibility testing
- high-dose INH and RMP
- MULTIDRUG-RESISTANT TUBERCULOSIS
- RANDOMIZED CONTROLLED-TRIAL
- ANTITUBERCULOSIS DRUGS
- PULMONARY TUBERCULOSIS