Model-based Cost-effectiveness of State-level Latent Tuberculosis Interventions in California, Florida, New York, and Texas
© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissionsoup.com..
BACKGROUND: Targeted testing and treatment (TTT) for latent tuberculosis (TB) infection (LTBI) is a recommended strategy to accelerate TB reductions and further TB elimination in the United States. Evidence on cost-effectiveness of TTT for key populations can help advance this goal.
METHODS: We used a model of TB transmission to estimate the numbers of individuals who could be tested by interferon-γ release assay and treated for LTBI with 3 months of self-administered rifapentine and isoniazid (3HP) under various TTT scenarios. Specifically, we considered rapidly scaling up TTT among people who are non-US-born, diabetic, living with human immunodeficiency virus (HIV), homeless or incarcerated in California, Florida, New York, and Texas-states where more than half of US TB cases occur. We projected costs (from the healthcare system perspective, in 2018 dollars), 30-year reductions in TB incidence, and incremental cost-effectiveness (cost per quality-adjusted life-year [QALY] gained) for TTT in each modeled population.
RESULTS: The projected cost-effectiveness of TTT differed substantially by state and population, while the health impact (number of TB cases averted) was consistently greatest among non-US-born individuals. TTT was most cost-effective among persons with HIV (from $2828/QALY gained in Florida to $11 265/QALY gained in New York) and least cost-effective among people with diabetes (from $223 041/QALY gained in California to $817 753/QALY in New York).
CONCLUSIONS: The modeled cost-effectiveness of TTT for LTBI varies across states but was consistently greatest among people with HIV; moderate among people who are non-US-born, incarcerated, or homeless; and least cost-effective among people with diabetes.
| Errataetall: |
CommentIn: Clin Infect Dis. 2021 Nov 2;73(9):e3483-e3485. - PMID 32588882 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:73 |
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| Enthalten in: |
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America - 73(2021), 9 vom: 02. Nov., Seite e3476-e3482 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Jo, Youngji [VerfasserIn] |
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| Links: |
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| Themen: |
Cost effectiveness |
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| Anmerkungen: |
Date Completed 10.11.2021 Date Revised 03.05.2022 published: Print CommentIn: Clin Infect Dis. 2021 Nov 2;73(9):e3483-e3485. - PMID 32588882 Citation Status MEDLINE |
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| doi: |
10.1093/cid/ciaa857 |
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| Förderinstitution / Projekttitel: |
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| 500 | |a published: Print | ||
| 500 | |a CommentIn: Clin Infect Dis. 2021 Nov 2;73(9):e3483-e3485. - PMID 32588882 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissionsoup.com. | ||
| 520 | |a BACKGROUND: Targeted testing and treatment (TTT) for latent tuberculosis (TB) infection (LTBI) is a recommended strategy to accelerate TB reductions and further TB elimination in the United States. Evidence on cost-effectiveness of TTT for key populations can help advance this goal | ||
| 520 | |a METHODS: We used a model of TB transmission to estimate the numbers of individuals who could be tested by interferon-γ release assay and treated for LTBI with 3 months of self-administered rifapentine and isoniazid (3HP) under various TTT scenarios. Specifically, we considered rapidly scaling up TTT among people who are non-US-born, diabetic, living with human immunodeficiency virus (HIV), homeless or incarcerated in California, Florida, New York, and Texas-states where more than half of US TB cases occur. We projected costs (from the healthcare system perspective, in 2018 dollars), 30-year reductions in TB incidence, and incremental cost-effectiveness (cost per quality-adjusted life-year [QALY] gained) for TTT in each modeled population | ||
| 520 | |a RESULTS: The projected cost-effectiveness of TTT differed substantially by state and population, while the health impact (number of TB cases averted) was consistently greatest among non-US-born individuals. TTT was most cost-effective among persons with HIV (from $2828/QALY gained in Florida to $11 265/QALY gained in New York) and least cost-effective among people with diabetes (from $223 041/QALY gained in California to $817 753/QALY in New York) | ||
| 520 | |a CONCLUSIONS: The modeled cost-effectiveness of TTT for LTBI varies across states but was consistently greatest among people with HIV; moderate among people who are non-US-born, incarcerated, or homeless; and least cost-effective among people with diabetes | ||
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| 650 | 4 | |a cost effectiveness | |
| 650 | 4 | |a latent tuberculosis | |
| 650 | 4 | |a targeting TB preventive therapy | |
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| 700 | 1 | |a Gomes, Isabella |e verfasserin |4 aut | |
| 700 | 1 | |a Marks, Suzanne |e verfasserin |4 aut | |
| 700 | 1 | |a Hill, Andrew |e verfasserin |4 aut | |
| 700 | 1 | |a Asay, Garrett |e verfasserin |4 aut | |
| 700 | 1 | |a Dowdy, David |e verfasserin |4 aut | |
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