Cost-effectiveness of tuberculosis screening and isoniazid treatment in the TB/HIV in Rio (THRio) Study

M. Azadi, David M Bishai, David Wesley Dowdy, Lawrence Hale Moulton, S. Cavalcante, V. Saraceni, A. G. Pacheco, S. Cohn, Richard E Chaisson, B. Durovni, Jonathan E Golub

Research output: Contribution to journalArticle

Abstract

DESIGN : We used decision analysis, populated by data from a cluster-randomized trial, to project the costs (in 2010 USD) and effectiveness (in disability-adjusted life years [DALYs] averted) of training health care workers to implement the tuberculin skin test (TST), followed by IPT for TST-positive patients with no evidence of active TB. This intervention was compared to a baseline of usual care. We used time horizons of 1 year for the intervention and 20 years for disease outcomes, with all future DALYs and medical costs discounted at 3% per year.

RESULTS : Providing this intervention to 100 people would avert 1.14 discounted DALYs (1.57 undiscounted DALYs). The median estimated incremental cost-effectiveness ratio was $2273 (IQR $1779-$3135) per DALY averted, less than Brazil's 2010 per capita gross domestic product (GDP) of $11 700. Results were most sensitive to the cost of providing the training.

CONCLUSION: Training health care workers to screen HIV-infected adults with TST and provide IPT to those with latent tuberculous infection can be considered costeffective relative to the Brazilian GDP per capita.

OBJECTIVE : To estimate the incremental cost-effectiveness of tuberculosis (TB) screening and isoniazid preventive therapy (IPT) among human immunodeficiency virus (HIV) infected adults in Rio de Janeiro, Brazil.

Original languageEnglish (US)
Pages (from-to)1443-1448
Number of pages6
JournalInternational Journal of Tuberculosis and Lung Disease
Volume18
Issue number12
DOIs
StatePublished - Dec 1 2014

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Quality-Adjusted Life Years
Isoniazid
Cost-Benefit Analysis
Tuberculosis
Tuberculin Test
HIV
Skin Tests
Gross Domestic Product
Costs and Cost Analysis
Brazil
Delivery of Health Care
Therapeutics
Decision Support Techniques
Infection

Keywords

  • Brazil
  • Economic analysis
  • IPT
  • Skin tests
  • TB-HIV co-infection

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases
  • Medicine(all)

Cite this

Cost-effectiveness of tuberculosis screening and isoniazid treatment in the TB/HIV in Rio (THRio) Study. / Azadi, M.; Bishai, David M; Dowdy, David Wesley; Moulton, Lawrence Hale; Cavalcante, S.; Saraceni, V.; Pacheco, A. G.; Cohn, S.; Chaisson, Richard E; Durovni, B.; Golub, Jonathan E.

In: International Journal of Tuberculosis and Lung Disease, Vol. 18, No. 12, 01.12.2014, p. 1443-1448.

Research output: Contribution to journalArticle

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