Evaluating the cost-effectiveness of levofloxacin therapy for household contacts of multidrug-resistant tuberculosis in Vietnam.
other · Level II
Where this comes from
- Record sourced from PubMed, PMID 40822287.
- Also identified by DOI 10.1016/j.lanwpc.2025.101666 and PMC identifier 12355538.
- Licence recorded as CC BY.
- The licence permits redistribution, so the abstract is shown in full and the full text is available from the publisher.
Abstract
Multidrug-resistant tuberculosis (TB) threatens global TB control, on account of poor treatment outcomes, high treatment toxicity and costs. Recent trials demonstrated the effectiveness of six-months of levofloxacin (6Lfx) to prevent TB disease among high-risk contacts. However, the cost-effectiveness of this strategy has not previously been evaluated. The VQUIN study was a double-blinded randomised control trial in Vietnam assessing the effectiveness of 6Lfx in household contacts of multidrug resistant/rifampicin resistant TB (MDR/RR-TB) to prevent progression to TB disease. Incorporating in-trial costs and effectiveness outcomes from the VQUIN trial, we developed a closed cohort, decision-analytic Markov model to assess the cost effectiveness of 6Lfx versus placebo in a cohort exposed to MDR/RR-TB in Vietnam. Over a 20-year time horizon, the provision of 6Lfx preventative therapy to household contacts of people infected with MDR/RR-TB was found to gain a total of 40.1 QALYs per 1000 population and save US$23,145 per 1000 population, indicating the strategy was cost saving. MDR/RR-TB cases averted over 20 years was 19.9 per 1000 population treated with 6Lfx, and the number of deaths averted was 3.2 per 1000 people treated. 6Lfx therapy is a cost-saving strategy to reduce the incidence of active disease in household contacts of MDR/RR-TB in a resource-limited setting. National Health and Medical Research Council Project Grant (#1081443). GJF was supported by a NHMRC Leadership Fellowship (Level 1) (#2007920).