[Cost effectiveness analysis of isoniazid preventive therapy to the contacts of tuberculosis patients under Japanese settings].
The target for isoniazid preventive therapy against tuberculosis in Japan has been contact persons of tuberculosis patients with the age of less than 30. This paper discusses about the cost effectiveness analysis of preventive therapy with the mathematical model. The effectiveness was measured with averted tuberculosis cases, averted death, averted loss of DALY (disability adjusted life years), averted loss of healthy years of life. With all indicators, isoniazid preventive therapy was effective if preventive chemotherapy is given to persons younger than 70 years old and with the higher probability of new infection than 20%, and if it is given following the present criteria of tuberculin testing for preventive therapy in Japan. The total medical cost is cheaper among persons with the preventive therapy than those without the preventive therapy, if the probability of new infection among the contact persons is more than 29% at the age of 40. The isoniazid preventive therapy for health care workers, whose prevalence of infection is higher than the average population, was also effective in both cases with and without baseline tuberculin testing. However, the positive predictive value of criteria of preventive therapy highly depends on the probability of new infection.
Yoshiyama
T
T
Epidemiology Division, Department of Applied Research, Research Institute of Tuberculosis.
D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000191:economics* / Q000627:therapeutic use*; D018890:Chemoprevention / Q000191:economics*; D003362:Cost-Benefit Analysis; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D006801:Humans; D007538:Isoniazid / Q000191:economics* / Q000627:therapeutic use*; D007564:Japan / Q000453:epidemiology; D008875:Middle Aged; D008962:Models, Theoretical; D014376:Tuberculosis / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission
D000995:Antitubercular Agents; D007538:Isoniazid