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Author Notes:

E-mail: david.p.holland@duke.edu

Conceived and designed the experiments: DPH GDS CDH JES.

Performed the experiments: DPH. Analyzed the data: DPH.

Wrote the paper: DPH.

Revised manuscript and approved final version: DPH GDS CDH JES.

The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

The authors have declared that no competing interests exist.

Subjects:

Research Funding:

The study was funded by National Institutes of Health grant 5K01AI083782-02.

Keywords:

  • Science & Technology
  • Multidisciplinary Sciences
  • Science & Technology - Other Topics
  • MULTIDISCIPLINARY SCIENCES
  • COST-EFFECTIVENESS ANALYSIS
  • DIRECTLY OBSERVED THERAPY
  • ISONIAZID PROPHYLAXIS
  • UNITED-STATES
  • PULMONARY TUBERCULOSIS
  • TREATMENT COMPLETION
  • HOUSEHOLD CONTACTS
  • RANDOMIZED-TRIAL
  • CLINICAL-TRIAL
  • LOW-RISK

Potential Economic Viability of Two Proposed Rifapentine-Based Regimens for Treatment of Latent Tuberculosis Infection

Tools:

Journal Title:

PLoS ONE

Volume:

Volume 6, Number 7

Publisher:

, Pages e22276-e22276

Type of Work:

Article | Final Publisher PDF

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: To inform clinical trial design by estimating the potential costs and effectiveness of rifapentine-based regimens for treatment of latent tuberculosis infection (LTBI). 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.

Copyright information:

© 2011 Holland et al.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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