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| Measure of outcomes | Cost effectiveness | Implications |
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Rose et al. [11] | Life years gained, quality-adjusted life years (QALYs) Incremental cost effectiveness ratio (ICER) | For high-risk reactors over 35, isoniazid dominates no intervention; cost savings and greater benefits (increased life expectancy). For low-risk reactors over 35, ICER of isoniazid over no intervention of $12,625 per year of life gained and $35,011 per death averted | Study can contribute to a change in existing policy and practice; consideration of INH therapy for all infected persons irrespective of age group and risk of tuberculin reactors |
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Salpeter et al. [12] | Number needed to treat, life years gained, and probability of survival at 1-year Cost saving | Isoniazid dominates no intervention for 35, 50 and 70 year olds; cost savings and increased life expectancy | Study can contribute to a change in existing policy and practice; consideration of all age groups for preventive therapy leading to potential public health benefits |
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Jasmer et al. [13] | Number of TB cases averted, number of TB-related deaths ICER | Isoniazid dominates no intervention; cost savings and increased life expectancy, more deaths prevented Isoniazid costs less than rifampin-pyrazinamide; both treatments have the same gain in life expectancy ICER of rifampin over no intervention of $2,494 per case prevented | Justify existing policy of INH prophylaxis |
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Diel et al. [14] | Number needed to treat, number of TB-related deaths avoided Cost saving | Isoniazid dominates no intervention for 20 and 40 year olds; cost savings, more cases, and TB-related deaths prevented | Acceleration of expansion of INH prevention |
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Holland et al. [15] | Life years gained, QALYs ICER | Rifampin dominates (self-administered and, directly observed) isoniazid; cost savings and more QALYs gained, more cases of active TB-prevented ICER of isoniazid-rifapentine over rifampinof $48,999 per QALY gained | Study can contribute to a change in existing policy and practice; highlights important knowledge gaps |
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Tan et al. [16] | Number of active TB cases prevented, QALYs Net monetary benefit | Test and treat (with isoniazid) more cost effective (in terms of net monetary benefit, the difference between benefits, valued at $50,000 per QALY, and costs) than no screening and treat all, for most subgroups | Justifies existing policy; support current practice of provision of treatment on the basis of TST size; exclusion of low-risk groups from screening and providing treatment to high-risk contacts without screening could improve the performance of the program |
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Fitzgerald and Gafni [17] | Number of TB cases prevented, life years gained Direct as well as indirect costs in different age groups | Average cost per case prevented in low-risk patients by isoniazid of $8,586 (20-year old), $28,260 (50 year old), and $40,102 (70-year old) | Justifies existing policy of INH prophylaxis; considers of all age groups; highlights importance of including indirect as well as direct costs |
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Ziakas and Mylonakis [18] | Hepatotoxicity, compliance Cost saving | Rifampin dominates isoniazid; cost savings and lower risk of noncompletion, lower rate of hepatotoxicity | Justifies existing policy; 9INH therapy is considered as standard of care |
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