title: Cost-effectiveness of a 12-dose regimen for treating latent tuberculous infection in the United States.
abstract: METHODS
  A large randomized controlled trial recently showed that for treating latent tuberculous infection (LTBI) in persons at high risk of progression to tuberculosis (TB) disease, a 12-dose regimen of weekly rifapentine plus isoniazid (3HP) administered as directly observed treatment (DOT) can be as effective as 9 months of daily self-administered isoniazid (9H).
  
  
  OBJECTIVE
  To assess the cost-effectiveness of 3HP compared to 9H.
  
  
  METHODS
  A computational model was designed to simulate individuals with LTBI treated with 9H or 3HP. Costs and health outcomes were estimated to determine the incremental costs per active TB case prevented and per quality-adjusted life year (QALY) gained by 3HP compared to 9H.
  
  
  RESULTS
  Over a 20-year period, treatment of LTBI with 3HP rather than 9H resulted in 5.2 fewer cases of TB and 25 fewer lost QALYs per 1000 individuals treated. From the health system and societal perspectives, 3HP would cost respectively US$21,525 and $4294 more per TB case prevented, and respectively $4565 and $911 more per QALY gained.
  
  
  CONCLUSIONS
  3HP may be a cost-effective alternative to 9H, particularly if the cost of rifapentine decreases, the effectiveness of 3HP can be maintained without DOT, and 3HP treatment is limited to those with a high risk of progression to TB disease.
authors.affiliation: Division of Tuberculosis Elimination, National Center for HIV/AIDS, Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA; Steven M Teutsch Prevention Effectiveness Fellowship Program, Office of Surveillance, Epidemiology and Laboratory Sciences, CDC, Atlanta, Georgia, USA; Department of Mathematics and Statistics, Mount Holyoke College, South Hadley, Massachusetts, USA.
authors.forename: D
authors.initials: D
authors.lastname: Shepardson
authors.forename: S M
authors.initials: SM
authors.lastname: Marks
authors.forename: H
authors.initials: H
authors.lastname: Chesson
authors.forename: A
authors.initials: A
authors.lastname: Kerrigan
authors.forename: D P
authors.initials: DP
authors.lastname: Holland
authors.forename: N
authors.initials: N
authors.lastname: Scott
authors.forename: X
authors.initials: X
authors.lastname: Tian
authors.forename: A S
authors.initials: AS
authors.lastname: Borisov
authors.forename: N
authors.initials: N
authors.lastname: Shang
authors.forename: C M
authors.initials: CM
authors.lastname: Heilig
authors.forename: T R
authors.initials: TR
authors.lastname: Sterling
authors.forename: M E
authors.initials: ME
authors.lastname: Villarino
authors.forename: W R
authors.initials: WR
authors.lastname: Mac Kenzie
mesh_terms: D000995:Antitubercular Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics*; D003198:Computer Simulation; D003362:Cost-Benefit Analysis; D023801:Directly Observed Therapy / Q000191:economics; D004334:Drug Administration Schedule; D016527:Drug Costs; D004359:Drug Therapy, Combination; D017721:Hospital Costs; D006801:Humans; D007538:Isoniazid / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics*; D055985:Latent Tuberculosis / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics*; D018803:Models, Economic; D019057:Quality-Adjusted Life Years; D012293:Rifampin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000191:economics; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
chemical_list: D000995:Antitubercular Agents; D007538:Isoniazid; D012293:Rifampin; C018421:rifapentine