A prevention effectiveness analysis framework was used to estimate the cost-effectiveness of a county administered tuberculosis prevention program along the U.S./Mexico border. The tuberculosis prevention program under study used prophylactic isoniazid therapy in patients who have tested positive for tuberculosis infection. This analysis determined the cost-effectiveness of the current program versus no program from the perspective of the county government and was modeled for two time periods; five years and 15 years post preventive therapy initiation. Costs were calculated using actual data from tuberculosis prevention and active tuberculosis treatment programs as well as hospital discharge data. The outcome of interest, cases of active tuberculosis averted, was calculated through a Monte Carlo simulated Markov process model. Average and incremental cost-effectiveness ratios were then calculated for the tuberculosis prevention program scenario. The cost-effectiveness ratios were calculated separately with the inclusion or exclusion of the tuberculosis contagion costs. The results of the cost-effectiveness ratio calculations established that the prevention of active tuberculosis cases with the tuberculosis prevention program is considerably cost-effective. Every baseline incremental cost-effectiveness ratio, across the five and 15 year analysis periods (irrespective of contagion costs) determined in this prevention effectiveness study demonstrated cost savings. Additionally, the cost savings were substantial. The results indicate that rather than incurring costs to avert active tuberculosis cases, the tuberculosis prevention program actually saves money. One-way sensitivity analyses were performed for selected parameters used in the calculation of the cost-effectiveness ratios. The cost-effective results obtained in the baseline analysis became sensitive when the percentage of patients hospitalized for tuberculosis decreased and when the preventive therapy compliance rate decreased for the 5 years post preventive treatment scenario with tuberculosis contagion costs excluded. However, when the tuberculosis contagion consequences of not having the tuberculosis prevention program were considered; the cost effectiveness and cost savings were once again realized.
| Identifer | oai:union.ndltd.org:arizona.edu/oai:arizona.openrepository.com:10150/282630 |
| Date | January 1998 |
| Creators | Borrego, Matthew Elvin, 1966- |
| Contributors | Draugalis, JoLaine R. |
| Publisher | The University of Arizona. |
| Source Sets | University of Arizona |
| Language | en_US |
| Detected Language | English |
| Type | text, Dissertation-Reproduction (electronic) |
| Rights | Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author. |
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