A model of the cost-effectiveness of directly observed therapy for treatment of tuberculosis
Palmer, C. S., Miller, B., Halpern, M., & Geiter, L. J. (1998). A model of the cost-effectiveness of directly observed therapy for treatment of tuberculosis. Journal of Public Health Management and Practice, 4(3), 1-13.
A hypothetical cohort of 25,000 TB patients and their contacts were followed for a 10-year period; rates of treatment default, infectiousness following partial treatment, relapse, hospitalization, and development of drug-resistant TB were included. The average cost per case cured was $16,846 with 15% of patients starting DOT, $17,323 with 100% starting DOT, and $20,106 with none starting DOT. The incremental cost per additional case cured was $24,064 when all patients, started treatment on DOT, indicating that outpatient DOT provides a cost-effective method of improving health outcomes for TB patients and their contacts while controlling direct costs