Introduction
Methods
Results
Author, year | Population, context, setting | study perspective | reference case | comparators | time horizon | Primary outcome | cost vs CEAc | Secondary/ health outcomes | WTP threshold | source of cost data | source of effectiveness data | currency, price date | choice of model | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Costing studies | Huang 2016 [25] | general populationa, Taiwan, hospital | health system | 9H DOT | 3HP DOT | 5 years | cost/ patient | cost | treatment completion, active TB, cost/case avoided | NA | empiric | published data | USDd2014 | NA |
Chen 2018 [26] | rheumatoid arthritis patients, Taiwan, clinic | health system | 9H DOT | 3HP DOT | 2 years | cost/ patient | cost | treatment completion, active TB, cost/case avoided | NA | empiric | NA | USDd2014 | NA | |
Wheeler 2019 [27] | Inmates, USA, prison clinic | health system | 9H DOT | 3HP DOT | no long-term follow-up | cost/ patient | cost | treatment completion | NA | empiric | NA | USD 2012 | NA | |
Cost effectiveness studies (HIC context) | Holland 2009 [28] | general population, USA, NSb | societal | no treatment | 9H SAT, 9H DOT, 3HP DOT, 4R | lifetime | ICER | CEA | active TB | $50,000 | mixed | mostly published | USD 2008 | Markov |
Holland 2011 [29] | general population, USA, NSb | societal | 9H SAT | 3HP SAT, 3HP DOT, 1HP SAT | lifetime | ICER | CEA | active TB | 0 | non-empiric | published | USD 2011 | Markov | |
Shepardson 2013 [30] | general population, USA, clinic | health system and societal | 9H SAT | 3HP DOT | 20 years | ICER | CEA | active TB | NSb | mixed | published data | USD 2010 | individual-based stochastic | |
Doan 2019 [31] | general population, USA, NSb | health system | serial radiographic surveillance | 3HP DOT, 3HP SAT, 3RH, 4R, 6H, 9H | 20 years or death | ICER | CEA | active TB | $50,000 | non-empiric | published data | USD 2018 | Markov | |
Pease, 2021 [32] | general population, Iqaluit, Canada | health system | 9H DOT (twice weekly) | 3HP DOT | 30 years | ICER | CEA | Cases and deaths averted | NSb | mostly empiric | programmatic | CAD 2019 | Markov | |
Cost effectiveness studies (LMIC context) | Johnson 2018 [33] | people living with HIV, Uganda, HIV clinic | health system | 9H SAT | 3HP-DOT | 20 years | ICER | CEA | active TB | sensitivity-tested $1000, $3000, $5000, $7000, $9000 | non-empiric | published data | USD 2017 | Markov |
Ferguson, 2020 [34] | people living with HIV, Uganda, HIV clinic | health system | 3HP DOT | 1HP SAT | 20 years | ICER | CEA | Active TB, TB deaths | NSb | Non-empiric | Published data | USD 2019 | Markov |
Costing-only studies
Study type | Cost/ patient 9H DOT | Cost/ patient 9H SAT | Cost/ patient 3HP DOT | Treatment completion 9H DOT | Treatment completion 9H SAT | Treatment completion 3HP DOT | ||
---|---|---|---|---|---|---|---|---|
Costing studies | Huang [25] | Costing | $784 | $286 | 0.873 | 0.97 | ||
Chen [26] | Costing | $784 | $286 | 0.783 | 0.905 | |||
Wheeler [27] | Costing | $636 | $676 | 0.42 | 0.9 | |||
Cost effectiveness studies (HIC) | Holland 2009 [28] | CE | $285 | $605 | 0.53 | 0.94 | ||
Holland 2011 [29] | CE | $287 | $609 | 0.53 | 0.9 | |||
Shepardson [30] | CE | $479 | $691 | 0.68 | 0.84 | |||
Doan [31] | CE | $496 | $619 | 0.52 | 0.85 | |||
Pease [32] | CE | $801 | $381 | 0.75 | 0.82 | |||
Cost effectiveness studies (LMIC context) | Johnson [33] | CE | $17 | $94 | 0.47 | 0.74 | ||
Ferguson [34] | CE | $23 | 0.74 |
Author | TB meds | physician time | nurse time | other worker time | “clinic visit” | travel | radiology | lab tests | patient time (lost wages) | treatment SAEs | hospitalization SAE | treatment active TB | hospitalization active TB | contact tracing | HIV meds | secondary transmission | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Costing studies | Huang [25] | Y | Y | ||||||||||||||
Chen [26] | Y | Y | |||||||||||||||
Wheeler [27] | Y | Y | Y | Y | Y | Y | |||||||||||
Cost effectiveness studies | Holland 2009 [28] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y | |||
Holland 2011 [29] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y | ||||
Shepardson 2013 [30] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y | ||||
Doan [31] | Y | Y | Y | Y | Y | Y | Y | Y | Y | ||||||||
Pease [32] | Y | Y | Y | Y | Y | Y | Y | Y | Y | ||||||||
LMIC context | Johnson [33] | Y | Y | Y | Y | ||||||||||||
Ferguson [34] | Y | Y | Y | Y |
Cost-effectiveness studies
Author | Holland 2009 [28] | Holland 2011 [29] | Shepardson [30] | Doan [31] | Pease [32] | Johnson [33] | Ferguson [34] |
---|---|---|---|---|---|---|---|
Selected epidemiologic parameters | |||||||
Risk reduction 9H SAT | 0.93 | 0.93 | 0.92 | 0.96 | 0.93b | 0.58 | na |
Risk reduction 3HP DOT | 0.93 | 0.93 | 0.95 | 0.975 | 0.93 | 0.63 | 0.90 |
Treatment completion 9H SAT | 0.53 | 0.53 | 0.68 | 0.52 | 0.75b | 0.47 | na |
Treatment completion 3HP DOT | 0.94 | 0.9 | 0.84 | 0.85 | 0.82 | 0.74 | 0.74 |
Adverse events 9H SAT | 0.014 | 0.014 | 0.055 | 0.023 | 0.065b | 0.034 | na |
Adverse events 3HP DOT | 0.014 | 0.05 | 0.082 | 0.016 | 0.057 | 0.034 | 0.034 |
Selected cost parametersa | |||||||
Treatment cost per regimen 9H SAT | 285 | 287 | 479 | 496 | 801b | 18 | na |
Treatment cost per regimen 3HP DOT | 605 | 609 | 691 | 619 | 381 | 94 | 23 |
Treatment cost of SAEs | 190 | 190 | 201 | Included in cost of hospitalization | Included in cost of hospitalization | Not included | Not included |
Cost of hospitalization SAEs | 6396 | 6372 | 6738 | 6670 | 2616 | Not included | Not included |
Cost active TB meds | 2460 | 2426 | 3542 | 3812 | 1517 | 230 | 230 |
Cost active TB hospitalization | 12,016 | 11,969 | 30,260 | 29,463 | 66,495 | Not included | Not included |
Cost/ patient 9H SAT | Cost/ patient 3HP DOT | Effectiveness (QALY gained/patient 9H SAT) | Effectiveness (QALY gained/patient 3HP DOT) | ICER 3HP DOT compared to 9H SAT (2020USD/QALY gained) | Total TB cases/ 1000 patients on 9H SAT | Total TB cases/ 1000 patients on 3HP DOT | |
---|---|---|---|---|---|---|---|
Holland 2009 [28] | $817 | $933 | 22.64505 | 22.67083 | a4511 | 20.3 | 8.7 |
Holland 2011 [29] | $833 | $868 | 22.64937 | 22.66836 | a1818 | 22 | 13 |
Shepardson 2013—health system [30] | $606 | $739 | 0.044d | 0.019d | 5418 | 9.1 | 3.9 |
Shepardson 2013—societal [30] | $837 | $864 | 0.044d | 0.019d | 1081 | 9.1 | 3.9 |
Shepardson 2014—health system [35] | Not stated | Not stated | Not stated | Not stated | 2054 | 9.1 | 3.9 |
Shepardson 2014—societal [35] | Not stated | Not stated | Not stated | Not stated | 3HP dominates | 9.1 | 3.9 |
Doan [31] | $1095 | $900 | 15.6161 | 15.6539 | a3HP dominates | 23.2 | 10.6 |
Pease [32] | $920c | $626 | 20.13c | 20.14 | 3HP dominates | 30.16 | 27.79 |
Johnson [33] | $2576 | $2640 | 10.843 | 10.837 | b9927 DALY averted | 37 | 28 |
Ferguson [34] | Not studied | $1541 | Not studied | 7.3697 | Not applicable | Not studied | 21.3 |