Abstract | RATIONALE:
Rifapentine-based regimens for treating latent tuberculosis infection (LTBI) are being considered for future clinical trials, but even if they prove effective, high drug costs may limit their economic viability. OBJECTIVES: METHODS: We used a Markov model to estimate cost and societal benefits for three regimens for treating LTBI: Isoniazid/ rifapentine daily for one month, isoniazid/ rifapentine weekly for three months (self-administered and directly-observed), and isoniazid daily for nine months; a strategy of "no treatment" used for comparison. Costs, quality-adjusted life-years gained, and instances of active tuberculosis averted were calculated for all arms. RESULTS: Both daily isoniazid/ rifapentine for one month and weekly isoniazid/ rifapentine for three months were less expensive and more effective than other strategies under a wide variety of clinically plausibly parameter estimates. Daily isoniazid/ rifapentine for one month was the least expensive and most effective regimen. CONCLUSIONS: Daily isoniazid/ rifapentine for one month and weekly isoniazid/ rifapentine for three months should be studied in a large-scale clinical trial for efficacy. Because both regimens performed well even if their efficacy is somewhat reduced, study designers should consider relaxing non-inferiority boundaries.
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Authors | David P Holland, Gillian D Sanders, Carol D Hamilton, Jason E Stout |
Journal | PloS one
(PLoS One)
Vol. 6
Issue 7
Pg. e22276
( 2011)
ISSN: 1932-6203 [Electronic] United States |
PMID | 21789248
(Publication Type: Journal Article, Research Support, N.I.H., Extramural)
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Chemical References |
- Antitubercular Agents
- Isoniazid
- Rifampin
- rifapentine
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Topics |
- Antitubercular Agents
(administration & dosage, economics, therapeutic use)
- Cost-Benefit Analysis
- Drug Administration Schedule
- Humans
- Isoniazid
(administration & dosage, economics, therapeutic use)
- Latent Tuberculosis
(drug therapy, economics)
- Models, Biological
- Patient Compliance
- Rifampin
(administration & dosage, analogs & derivatives, economics, therapeutic use)
- Self Administration
- United States
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