To compare the costs and effectiveness of directly observed therapy (DOT) vs self-administered therapy (SAT) for the treatment of active tuberculosis.
We used published rates for failure of therapy, relapse, and acquired multidrug resistance during the initial treatment of drug-susceptible tuberculosis cases using DOT or SAT.
We estimated costs of tuberculosis treatment at an urban tuberculosis control program, a municipal hospital, and a hospital specializing in treating drug-resistant tuberculosis.
The average cost per patient to cure drug-susceptible tuberculosis, including the cost of treating failures of initial treatment.
The direct costs of initial therapy with DOT and SAT were similar ($1,206 vs $1,221 per patient, respectively), although DOT was more expensive when patient time costs were included.
When the costs of relapse and failure were included in the model, DOT was less expensive than SAT, whether considering outpatient costs only ($1,405 vs $2,314 per patient treated), outpatient plus inpatient costs ($2,785 vs $10,529 per patient treated), or outpatient, inpatient, and patients'time costs ($3,999 vs $12,167 per patient treated).
Threshold analysis demonstrated that DOT was less expensive than SAT through a wide range of cost estimates and clinical event rates. (...)
Mots-clés Pascal : Tuberculose, Mycobactériose, Bactériose, Infection, Antituberculeux, Observance médicamenteuse, Contrôle, Autoadministration, Analyse, Rapport coût bénéfice, Etude comparative, Homme, Antibiotique, Chimiothérapie, Traitement
Mots-clés Pascal anglais : Tuberculosis, Mycobacterial infection, Bacteriosis, Infection, Antituberculous agent, Drug compliance, Check, Self administration, Analysis, Cost benefit ratio, Comparative study, Human, Antibiotic, Chemotherapy, Treatment
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0411869
Code Inist : 002B02S02. Création : 19/12/1997.