Cost-Effectiveness of Treating Multidrug-Resistant Tuberculosis 英文参考文献.docVIP

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Cost-Effectiveness of Treating Multidrug-Resistant Tuberculosis 英文参考文献.doc

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Cost-Effectiveness of Treating Multidrug-Resistant Tuberculosis 英文参考文献

o PL SMEDICINE Cost-EffectivenessofTreating Multidrug-ResistantTuberculosis Stephen C.Resch1*,Joshua A.Salomon2,3,Megan Murray4,5,Milton C.Weinstein1,5 1DepartmentofHealthPolicyandManagement,HarvardSchoolofPublicHealth,HarvardUniversity,Boston,Massachusetts,UnitedStatesofAmerica,2Departmentof PopulationandInternationalHealth,HarvardSchoolofPublicHealth,HarvardUniversity,Boston,Massachusetts,UnitedStatesofAmerica,3HarvardInitiativeforGlobal Health,HarvardUniversity,Cambridge,Massachusetts,UnitedStatesofAmerica,4DepartmentofEpidemiology,HarvardSchoolofPublicHealth,HarvardUniversity,Boston, Massachusetts,United StatesofAmerica, 5Division ofSocialMedicineandHealth Inequalities, Brighamand Women’sHospital,Boston, Massachusetts, UnitedStates of America Funding:Thisstudywassupported bygrantsfromtheBillandMelinda GatesFoundationthroughthe foundation’sgranttothe ABSTRACT Background DepartmentofSocialMedicineat HarvardMedicalSchoolandto PartnersInHealth,andfromthe NationalInstituteforAllergyand InfectiousDiseases(T32AI07433– 12).Thefundershadnoroleinstudy design,datacollectionandanalysis, decisiontopublish,orpreparation ofthemanuscript. Despitetheexistenceofeffectivedrugtreatments,tuberculosis(TB)causes2milliondeaths annually worldwide. Effective treatment is complicated by multidrug-resistant TB (MDR TB) strains that respond only to second-line drugs. We projected the health benefits and cost- effectiveness of using drug susceptibility testing and second-line drugs in a lower-middle- incomesettingwithhighlevelsofMDRTB. MethodsandFindings CompetingInterests:Theauthors havedeclaredthatnocompeting interestsexist. Wedevelopedadynamicstate-transitionmodelofTB.Inabasecaseanalysis,themodelwas calibratedtoapproximatetheTBepidemicinPeru,asettingwithasmear-positiveTBincidence of120per100,000and4.5%MDRTBamongprevalentcases.Secondaryanalysesconsidered other settings. The following strategies were evaluated: first-line drugs administered under directlyobservedtherapy(DOTS),locall