Abstract：
OBJECTIVE: Several model studies suggested the implementation of latent tuberculosis infection (LTBI) testing and treatment could greatly reduce the incidence of tuberculosis (TB) and achieve the 2035 target of the \"End TB\" Strategy in China. The present study aimed to evaluate the cost-effectiveness of LTBI testing and TB preventive treatment among key population (≥ 50 years old) susceptible to TB at community level in China.
METHODS: A Markov model was developed to investigate the cost-effectiveness of LTBI testing using interferon gamma release assay (IGRA) and subsequent treatment with 6-month daily isoniazid regimen (6H) (as a standard regimen for comparison) or 6-week twice-weekly rifapentine and isoniazid regimen (6-week H2P2) in a cohort of 10,000 adults with an average initial age of 50 years.
RESULTS: In the base-case analysis, LTBI testing and treatment with 6H was dominated (i.e., more expensive with a lower quality-adjusted life year (QALY)) by LTBI testing and treatment with 6-week H2P2. LTBI testing and treatment with 6-week H2P2 was more effective than no intervention at a cost of $20,943.81 per QALY gained, which was below the willingness-to-pay (WTP) threshold of $24,211.84 per QALY gained in China. The one-way sensitivity analysis showed the change of LTBI prevalence was the parameter that most influenced the results of the incremental cost-effectiveness ratios (ICERs).
CONCLUSIONS: As estimated by a Markov model, LTBI testing and treatment with 6-week H2P2 was cost-saving compared with LTBI testing and treatment with 6H, and it was considered to be a cost-effective option for TB control in rural China.
METHODS: A Markov model was developed to investigate the cost-effectiveness of LTBI testing using interferon gamma release assay (IGRA) and subsequent treatment with 6-month daily isoniazid regimen (6H) (as a standard regimen for comparison) or 6-week twice-weekly rifapentine and isoniazid regimen (6-week H2P2) in a cohort of 10,000 adults with an average initial age of 50 years.
RESULTS: In the base-case analysis, LTBI testing and treatment with 6H was dominated (i.e., more expensive with a lower quality-adjusted life year (QALY)) by LTBI testing and treatment with 6-week H2P2. LTBI testing and treatment with 6-week H2P2 was more effective than no intervention at a cost of $20,943.81 per QALY gained, which was below the willingness-to-pay (WTP) threshold of $24,211.84 per QALY gained in China. The one-way sensitivity analysis showed the change of LTBI prevalence was the parameter that most influenced the results of the incremental cost-effectiveness ratios (ICERs).
CONCLUSIONS: As estimated by a Markov model, LTBI testing and treatment with 6-week H2P2 was cost-saving compared with LTBI testing and treatment with 6H, and it was considered to be a cost-effective option for TB control in rural China.
摘要：
目的：多项模型研究表明，实施潜伏性结核感染（LTBI）检测和治疗可以大大降低结核病（TB）的发病率，并实现“终止结核病”战略的2035目标。中国。本研究的目的是评估LTBI检测和结核病预防治疗在中国社区范围内的主要人群（≥50岁）的成本效益。
方法：建立了一个马尔可夫模型，以研究使用干扰素γ释放试验（IGRA）进行LTBI测试的成本效益，以及随后使用6个月每日异烟肼方案（6H）（作为比较的标准方案）或6周每周两次的利福喷丁和异烟肼方案（6周H2P2）治疗的10,000名成年人，平均初始年龄为50岁。
结果：在基本案例分析中，LTBI测试和6H治疗占主导地位(即，通过LTBI测试和6周H2P2治疗，在质量调整生命年（QALY）较低的情况下更昂贵）。LTBI测试和6周H2P2治疗比没有干预更有效，每QALY获得20,943.81美元，低于在中国获得的每QALY24,211.84美元的支付意愿(WTP)门槛。单向敏感性分析显示，LTBI患病率的变化是对增量成本效益比（ICER）结果影响最大的参数。
结论：根据马尔可夫模型的估计，与使用6H的LTBI测试和治疗相比，使用6周H2P2的LTBI测试和治疗节省成本，它被认为是中国农村结核病控制的一种具有成本效益的选择。
方法：建立了一个马尔可夫模型，以研究使用干扰素γ释放试验（IGRA）进行LTBI测试的成本效益，以及随后使用6个月每日异烟肼方案（6H）（作为比较的标准方案）或6周每周两次的利福喷丁和异烟肼方案（6周H2P2）治疗的10,000名成年人，平均初始年龄为50岁。
结果：在基本案例分析中，LTBI测试和6H治疗占主导地位(即，通过LTBI测试和6周H2P2治疗，在质量调整生命年（QALY）较低的情况下更昂贵）。LTBI测试和6周H2P2治疗比没有干预更有效，每QALY获得20,943.81美元，低于在中国获得的每QALY24,211.84美元的支付意愿(WTP)门槛。单向敏感性分析显示，LTBI患病率的变化是对增量成本效益比（ICER）结果影响最大的参数。
结论：根据马尔可夫模型的估计，与使用6H的LTBI测试和治疗相比，使用6周H2P2的LTBI测试和治疗节省成本，它被认为是中国农村结核病控制的一种具有成本效益的选择。
