PLoS ONE (Jan 2022)

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

  • Jangmi Yang,
  • Hae-Young Kim,
  • Seup Park,
  • Ilham Sentissi,
  • Nathan Green,
  • Byung Kwon Oh,
  • Yujin Kim,
  • Kyung Hyun Oh,
  • Eunseong Paek,
  • Young Joon Park,
  • In-Hwan Oh,
  • Seung Heon Lee

DOI
https://doi.org/10.1371/journal.pone.0267292
Journal volume & issue
Vol. 17, no. 4
p. e0267292

Abstract

Read online

BackgroundDigital health technologies have been used to enhance adherence to TB medication, but the cost-effectiveness remains unclear.MethodsWe 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.ResultsThe 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.ConclusionMEMS is considered cost-effective for managing infectious active TB in Morocco.