{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T13:54:51Z","timestamp":1762005291028,"version":"3.41.2"},"reference-count":29,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2020,10,26]],"date-time":"2020-10-26T00:00:00Z","timestamp":1603670400000},"content-version":"vor","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J. Intern. AIDS Soc."],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>In 2017, the Aurum Institute, with support from Unitaid, launched an initiative to expand short\u2010course therapy for the prevention of tuberculosis (TB) in 12 high\u2010burden countries. This study aimed to investigate the importance of \u201ccatalytic\u201d effects beyond the original project timeframe when estimating cost\u2010effectiveness of such large investments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We estimated the cost\u2010effectiveness of the IMPAACT4TB (I4TB) initiative from a health system perspective, using a 10\u2010year time horizon. We first conservatively estimated costs using a \u201ctop\u2010down\u201d approach considering only the direct health benefits of providing TB preventive therapy to people initiating antiretroviral therapy (ART) through I4TB activities. We then re\u2010estimated the incremental cost\u2010effectiveness of I4TB incorporating the costs and health benefits of potential catalytic effects beyond the program itself.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We estimated that TB preventive therapy through the I4TB initiative alone would prevent 14\u00a0201 cases of active TB and 1562\u00a0TB deaths over 10\u00a0years with an up\u2010front investment of $52.5\u00a0million; the estimated incremental cost\u2010effectiveness was $1580 per disability\u2010adjusted life year (DALY) averted. If this initiative could achieve its desired catalytic effects, an additional 375\u00a0648 cases and 41\u00a0321 deaths could be averted, at an incremental cost of $546\u00a0million and cost\u2010effectiveness of $713 per DALY averted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings provide donors with reasonable evidence of value for money to support investment in short\u2010course TB preventive therapy for people initiating ART in high\u2010burden settings. Our study also illustrates the importance of considering long\u2010term secondary (\u201ccatalytic\u201d) effects when evaluating the cost\u2010effectiveness of large\u2010scale initiatives designed to change a global policy landscape.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25629","type":"journal-article","created":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T05:28:55Z","timestamp":1603776535000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Cost\u2010effectiveness of a 12 country\u2010intervention to scale up short course TB preventive therapy among people living with HIV"],"prefix":"10.1002","volume":"23","author":[{"given":"Hyejeong","family":"Shin","sequence":"first","affiliation":[{"name":"Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Youngji","family":"Jo","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard E","family":"Chaisson","sequence":"additional","affiliation":[{"name":"Center for Tuberculosis Research Johns Hopkins University School of Medicine Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karin","family":"Turner","sequence":"additional","affiliation":[{"name":"The Aurum Institute Parktown South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gavin","family":"Churchyard","sequence":"additional","affiliation":[{"name":"The Aurum Institute Parktown South Africa"},{"name":"School of Public Health University of Witwatersrand Johannesburg South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0481-7475","authenticated-orcid":false,"given":"David W.","family":"Dowdy","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD USA"},{"name":"Center for Tuberculosis Research Johns Hopkins University School of Medicine Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,10,26]]},"reference":[{"issue":"49","key":"e_1_2_9_2_1","first-page":"361","article-title":"Tuberculosis preventive therapy in HIV\u2010infected individuals. 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