{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T01:10:56Z","timestamp":1778202656142,"version":"3.51.4"},"reference-count":51,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R01 AI093269"],"award-info":[{"award-number":["R01 AI093269"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R37 AI058736"],"award-info":[{"award-number":["R37 AI058736"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["R01 HD111355"],"award-info":[{"award-number":["R01 HD111355"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Long-acting tuberculosis (TB) drugs could improve treatment outcomes in South Africa, where there is high prevalence of HIV and TB coinfection and high attrition from standard TB treatment, but potential benefits must be weighed against costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To identify scenarios where a long-acting TB treatment would provide clinical benefit and be cost-effective compared with standard TB treatment for people with HIV in South Africa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used a microsimulation model to compare clinical and cost outcomes of (1) standard-of-care 6-month oral TB treatment (SOC); and (2) a long-acting treatment regimen, entailing standard oral therapy for 2\u2009months followed by a one-time injection (LA). Base case parameters for the SOC\/LA strategies included efficacy, 97.6%\/97.6%; disengagement on oral therapy, 4.8% per month; TB relapse, 0.34%\/0.34% per month starting 5\u2009months after regimen completion; and total regimen cost, US$50.40\/$199.80 (cost of long-acting injectable drug alone, $175). We varied these parameters in sensitivity analysis. Outcomes included mortality, treatment completions, TB relapses, life-years, and health system costs. We defined LA to be cost-effective compared to SOC when its incremental cost-effectiveness ratio (ICER) was &amp;lt;$3,000 per year-of-life saved (YLS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In base case simulations, the LA strategy would produce lower all-cause mortality (11.4% vs 11.6%) and less disengagement (12.9% vs 20.9%) than SOC at 6\u2009months. LA would be cost-effective in the base case at the lifetime horizon (ICER $520\/YLS) and at 24\u2009months (ICER $2230\/YLS). Over the lifetime horizon, LA would be cost-effective compared with SOC over all parameter ranges evaluated in one-way sensitivity analysis. At 24\u2009months, LA would not be cost-effective compared to SOC when LA efficacy is &amp;lt;96%, monthly probability of disengagement from the oral regimen component of SOC and LA is &amp;lt;4%, or cost of the long-acting injectable drug is &amp;gt;$200.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There are combinations of efficacy, cost, and care disengagement at which a long-acting injectable TB treatment regimen could be cost-effective compared with the conventional oral treatment. Cost-effectiveness could be achieved if the long-acting treatment regimen maintains high efficacy at reasonable cost, especially when disengagement from \u00adstandard oral treatment is high.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/annalsats\/aaoaf072","type":"journal-article","created":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T14:20:56Z","timestamp":1771683656000},"page":"745-753","source":"Crossref","is-referenced-by-count":0,"title":["Potential long-acting tuberculosis treatment for people with HIV: cost-effectiveness benchmarks"],"prefix":"10.1093","volume":"23","author":[{"given":"Amy","family":"Zheng","sequence":"first","affiliation":[{"name":"Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University Irving Medical Center , New York, NY,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eden","family":"Pletner","sequence":"additional","affiliation":[{"name":"Medical Practice Evaluation Center, Massachusetts General Hospital , Boston, MA,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keren","family":"Middelkoop","sequence":"additional","affiliation":[{"name":"Institute of Infectious Disease and Molecular Medicine, University of Cape Town , Cape Town,","place":["South Africa"]},{"name":"Desmond Tutu HIV Centre, Department of Medicine, University of Cape Town , Cape Town,","place":["South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne M","family":"Neilan","sequence":"additional","affiliation":[{"name":"Medical Practice Evaluation Center, Massachusetts General Hospital , Boston, MA,","place":["United States"]},{"name":"Harvard Medical School Department of Medicine, , Boston, MA,","place":["United States"]},{"name":"Division of Infectious Diseases, Massachusetts General Hospital , Boston, MA,","place":["United States"]},{"name":"Division of Pediatrics, Massachusetts General Hospital , Boston, MA,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C Robert","family":"Horsburgh","sequence":"additional","affiliation":[{"name":"Departments of Epidemiology, Biostatistics and Global Health, Boston University School of Public Health , Boston, MA,","place":["United States"]},{"name":"Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine , Boston, MA,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A David","family":"Paltiel","sequence":"additional","affiliation":[{"name":"Public Health Modeling Unit, Yale School of Public Health , New Haven, CT,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth A","family":"Freedberg","sequence":"additional","affiliation":[{"name":"Medical Practice Evaluation Center, Massachusetts General Hospital , Boston, MA,","place":["United States"]},{"name":"Harvard Medical School Department of Medicine, , Boston, MA,","place":["United States"]},{"name":"Division of General Internal Medicine, Massachusetts General Hospital , Boston, MA,","place":["United States"]},{"name":"Department of Health Policy and Management, Harvard T.H. 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