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Cost-effectiveness of a medication event monitoring system for tuberculosis management in Morocco

Yang, Jangmi; Kim, Hae-Young; Park, Seup; Sentissi, Ilham; Green, Nathan; Oh, Byung Kwon; Kim, Yujin; ... Lee, Seung Heon; + view all (2022) Cost-effectiveness of a medication event monitoring system for tuberculosis management in Morocco. PLOS ONE , 17 (4) , Article e0267292. 10.1371/journal.pone.0267292. Green open access

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Abstract

BACKGROUND: Digital health technologies have been used to enhance adherence to TB medication, but the cost-effectiveness remains unclear. METHODS: We used the real data from the study conducted from April 2014 to December 2020 in Morocco using a smart pillbox with a web-based medication monitoring system, called Medication Event Monitoring Systems (MEMS). Cost-effectiveness was evaluated using a decision analysis model including Markov model for Multi-drug resistant (MDR) TB from the health system perspective. The primary outcome was the incremental cost-effectiveness ratio (ICER) per disability adjusted life-year (DALY) averted. Two-way sensitive analysis was done for the treatment success rate between MEMS and standard of care. RESULTS: The average total per-patient health system costs for treating a new TB patient under MEMS versus standard of care were $398.70 and $155.70, respectively. The MEMS strategy would reduce the number of drug-susceptible TB cases by 0.17 and MDR-TB cases by 0.01 per patient over five years. The ICER of MEMS was $434/DALY averted relative to standard of care, and was most susceptible to the TB treatment success rate of both strategies followed by the managing cost of MEMS. CONCLUSION: MEMS is considered cost-effective for managing infectious active TB in Morocco.

Type: Article
Title: Cost-effectiveness of a medication event monitoring system for tuberculosis management in Morocco
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1371/journal.pone.0267292
Publisher version: https://doi.org/10.1371/journal.pone.0267292
Language: English
Additional information: Copyright © 2022 Yang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Keywords: Tuberculosis, Multi-drug-resistant tuberculosis, Drug therapy, Treatment guidelines, Cost-effectiveness analysis, Morocco, Death rates, Tuberculosis diagnosis and management
UCL classification: UCL
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences > Dept of Statistical Science
URI: https://discovery-pp.ucl.ac.uk/id/eprint/10160160
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