Unit costs and cost-effectiveness of a device to improve TB treatment adherence in China
BACKGROUND: Adherence to TB drugs is crucial for improving treatment outcomes. Digital adherence technologies can improve adherence; however, there is a lack of evidence on cost-effectiveness. This study aimed to explore the cost-effectiveness of medication event reminder monitors (MERM) in China co...
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| Format: | Article |
| Language: | English |
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International Union Against Tuberculosis and Lung Disease (The Union)
2024-07-01
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| Series: | IJTLD Open |
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| Online Access: | https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000007/art00004 |
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| author | S. Sweeney K. Fielding X. Liu J.A. Thompson H. Dong S. Jiang Y. Zhao S. Huan A. Vassall |
| author_facet | S. Sweeney K. Fielding X. Liu J.A. Thompson H. Dong S. Jiang Y. Zhao S. Huan A. Vassall |
| author_sort | S. Sweeney |
| collection | DOAJ |
| description | BACKGROUND: Adherence to TB drugs is crucial for improving treatment outcomes. Digital adherence technologies can improve adherence; however, there is a lack of evidence on cost-effectiveness. This study aimed to explore the cost-effectiveness of medication event reminder monitors (MERM) in China compared with the standard of care, using results from a pragmatic, cluster-randomised superiority trial of an electronic MERM in China. METHODS: We collected primary unit cost data from the societal perspective, both at and above the health facility level. We estimated the incremental cost-effectiveness of MERM using a Markov model with a 20-year time horizon; a 3% discount rate was applied to costs and outcomes. We explored uncertainty through a series of sensitivity and scenario analyses. RESULTS: The incremental cost of MERM was $27.22 per patient. Probabilistic sensitivity analysis showed significant uncertainty about the intervention's cost-effectiveness. Changing assumptions around key parameters substantially affected our estimated incremental cost-effectiveness ratio. CONCLUSIONS: Although the incremental cost of the MERM box was low, current evidence does not indicate that the intervention would be cost-effective. However, the intervention's cost-effectiveness could improve if implemented as part of a broader strategy, including enhanced patient management. |
| format | Article |
| id | doaj-art-302e9ce8f6554d78a1c90e769f920530 |
| institution | Kabale University |
| issn | 3005-7590 |
| language | English |
| publishDate | 2024-07-01 |
| publisher | International Union Against Tuberculosis and Lung Disease (The Union) |
| record_format | Article |
| series | IJTLD Open |
| spelling | doaj-art-302e9ce8f6554d78a1c90e769f9205302025-01-22T12:12:38ZengInternational Union Against Tuberculosis and Lung Disease (The Union)IJTLD Open3005-75902024-07-011729930510.5588/ijtldopen.23.04514Unit costs and cost-effectiveness of a device to improve TB treatment adherence in ChinaS. Sweeney0K. Fielding1X. Liu2J.A. Thompson3H. Dong4S. Jiang5Y. Zhao6S. Huan7A. Vassall8London School of Hygiene & Tropical Medicine, London, UK;London School of Hygiene & Tropical Medicine, London, UK;National Center for TB Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China:London School of Hygiene & Tropical Medicine, London, UK;PATH China Office, Beijing, China;National Center for TB Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China:National Center for TB Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China:Bill & Melinda Gates Foundation China Office, Beijing, ChinaLondon School of Hygiene & Tropical Medicine, London, UK;BACKGROUND: Adherence to TB drugs is crucial for improving treatment outcomes. Digital adherence technologies can improve adherence; however, there is a lack of evidence on cost-effectiveness. This study aimed to explore the cost-effectiveness of medication event reminder monitors (MERM) in China compared with the standard of care, using results from a pragmatic, cluster-randomised superiority trial of an electronic MERM in China. METHODS: We collected primary unit cost data from the societal perspective, both at and above the health facility level. We estimated the incremental cost-effectiveness of MERM using a Markov model with a 20-year time horizon; a 3% discount rate was applied to costs and outcomes. We explored uncertainty through a series of sensitivity and scenario analyses. RESULTS: The incremental cost of MERM was $27.22 per patient. Probabilistic sensitivity analysis showed significant uncertainty about the intervention's cost-effectiveness. Changing assumptions around key parameters substantially affected our estimated incremental cost-effectiveness ratio. CONCLUSIONS: Although the incremental cost of the MERM box was low, current evidence does not indicate that the intervention would be cost-effective. However, the intervention's cost-effectiveness could improve if implemented as part of a broader strategy, including enhanced patient management.https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000007/art00004mermchinadigital adherence technologydateconomicstuberculosismedication event reminder monitor |
| spellingShingle | S. Sweeney K. Fielding X. Liu J.A. Thompson H. Dong S. Jiang Y. Zhao S. Huan A. Vassall Unit costs and cost-effectiveness of a device to improve TB treatment adherence in China IJTLD Open merm china digital adherence technology dat economics tuberculosis medication event reminder monitor |
| title | Unit costs and cost-effectiveness of a device to improve TB treatment adherence in China |
| title_full | Unit costs and cost-effectiveness of a device to improve TB treatment adherence in China |
| title_fullStr | Unit costs and cost-effectiveness of a device to improve TB treatment adherence in China |
| title_full_unstemmed | Unit costs and cost-effectiveness of a device to improve TB treatment adherence in China |
| title_short | Unit costs and cost-effectiveness of a device to improve TB treatment adherence in China |
| title_sort | unit costs and cost effectiveness of a device to improve tb treatment adherence in china |
| topic | merm china digital adherence technology dat economics tuberculosis medication event reminder monitor |
| url | https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000007/art00004 |
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