Tuberculosis Therapy: Isoniazid More Cost-Effective Than Rifampin-Pyrazinamide for Latent TB Treatment

Research from California indicates that isoniazid is more cost-effective that rifampin-pyrazinamide regimens for treating latent TB infections.

According to R.M. Jasmer and coauthors at San Francisco General Hospital, "2 months of treatment with rifampin-pyrazinamide (RZ) and 9 months of treatment with isoniazid are both recommended for latent tuberculosis infection in adults without human immunodeficiency virus infection, but the relative cost-effectiveness of these two treatments is unknown."

The researchers used a Markov model to conduct a cost-effectiveness analysis to assess the impact on life expectancy and costs based on the results of a recent clinical trial that compared the rates of adverse events and completion for the two regimens.

"Compared with no treatment, both regimens increased life expectancy by 1.2 years, but RZ cost $273 more per patient. Sensitivity analyses showed that, assuming equal efficacy between the two regiments, there was no threshold completion rate for RZ at which the two treatments would be of equal cost," according to the researchers.

Compared with RZ treatment, "under most circumstances, treatment of latent tuberculosis infection with isoniazid is cost-saving," the investigators concluded.

The full report, "Short-Course Rifampin and Pyrazinamide Compared With Isoniazid for Latent Tuberculosis Infection: A Cost-Effectiveness Analysis Based on a Multicenter Clinical Trial," was published in Clinical Infectious Diseases (2004;38(3):363-369).

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