Strengthening tuberculosis control overseas: who benefits?

Nguyen, Hoa Thi Minh, Hickson, Roslyn I., Kompas, Tom, Mercer, Geoffry N., and Lokuge, Kamalini M. (2015) Strengthening tuberculosis control overseas: who benefits? Value in Health, 18 (2). pp. 180-188.

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Background: Although tuberculosis is a major cause of morbidity and mortality worldwide, available funding falls far short of that required for effective control. Economic and spillover consequences of investments in the treatment of tuberculosis are unclear, particularly when steep gradients in the disease and response are linked by population movements, such as that between Papua New Guinea (PNG) and the Australian cross border region.

Objective: to undertake an economic evaluation of Australian support for the expansion of basic Directly Observed Treatment, Short Course in the PNG border area of the South Fly from the current level of 14% coverage.

Methods: Both cost utility analysis and cost-benefit analysis were applied to models that allow for population movement across regions with different characteristics of tuberculosis burden, transmission, and access to treatment. Cost benefit data were drawn primarily from estimates published by the World Health Organization, and disease transmission data were drawn from a previously published model.

Results: Investing $16 million to increase basic Directly Observed Treatment, Short Course coverage in the South Fly generates a net present value of roughly $74 million for Australia (discounted 2005 dollars). The cost per disabilityadjusted life-year averted and quality-adjusted life-year saved for PNG is $7 and $4.6, respectively.

Conclusions: Where regions with major disparities in tuberculosis burden and health system resourcing are connected through population movements, investments in tuberculosis control are of mutual benefit, resulting in net health and economic gains on both sides of the border. These findings are likely to inform the case for appropriate investment in tuberculosis control globally.

Item ID: 64150
Item Type: Article (Research - C1)
ISSN: 1524-4733
Keywords: Australia; cost-benefit analysis; cost-utility analysis; DOTS; metapopulation model; PNG; tuberculosis control
Copyright Information: Copyright & 2015, International Society for Pharmacoeconomics and Outcomes Research (ISPOR).
Date Deposited: 26 Aug 2020 05:23
FoR Codes: 14 ECONOMICS > 1402 Applied Economics > 140208 Health Economics @ 60%
01 MATHEMATICAL SCIENCES > 0102 Applied Mathematics > 010202 Biological Mathematics @ 10%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111706 Epidemiology @ 30%
SEO Codes: 92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920404 Disease Distribution and Transmission (incl. Surveillance and Response) @ 90%
97 EXPANDING KNOWLEDGE > 970114 Expanding Knowledge in Economics @ 10%
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