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50 result(s)
Journal Article > ResearchFull Text

Evaluation of a decentralised model of care on case isolation and patient outcomes during the 2018–20 Ebola outbreak in the Democratic Republic of the Congo: a retrospective observational study

Lancet Global Health. 25 March 2025; Online ahead of print; DOI:10.1016/S2214-109X(25)00011-7
Barks PM, Camacho A, Newport T, Ribeiro F, Ahuka-Mundeke S,  et al.
Lancet Global Health. 25 March 2025; Online ahead of print; DOI:10.1016/S2214-109X(25)00011-7
Journal Article > CommentaryFull Text

Medical oxygen: a necessity or a luxury in humanitarian settings?

Lancet Global Health. 3 February 2025; Online ahead of print; DOI:10.1016/S2214-109X(24)00509-6
Godard A, Phalkey R, Shepherd S, Rossi S, Tessema MT,  et al.
Lancet Global Health. 3 February 2025; Online ahead of print; DOI:10.1016/S2214-109X(24)00509-6
Journal Article > ResearchFull Text

24-week, all-oral regimens for pulmonary rifampicin-resistant tuberculosis in TB-PRACTECAL trial sites: an economic evaluation

Lancet Global Health. 1 February 2025; Volume 13 (Issue 2); e355-e363.; DOI:10.1016/S2214-109X(24)00467-4
Sweeney S, Laurence YV, Berry C, Singh MP, Dodd M,  et al.
Lancet Global Health. 1 February 2025; Volume 13 (Issue 2); e355-e363.; DOI:10.1016/S2214-109X(24)00467-4

BACKGROUND

New 6-month rifampicin-resistant tuberculosis treatment regimens containing bedaquiline, pretomanid, and linezolid (BPaL) with or without moxifloxacin or clofazimine, could improve treatment efficacy, safety, and tolerability, and free up resources within the health system. Following a change to WHO rifampicin-resistant tuberculosis treatment guidelines, countries are facing difficult decisions about when and how to incorporate new drug regimens into national guidelines. We aimed to assess the probability of BPaL-based regimens being cost-saving using data collected in the TB-PRACTECAL trial.


METHODS

This economic evaluation using a cost-utility analysis was embedded in five TB-PRACTECAL trial sites in Belarus, Uzbekistan, and South Africa. Between Nov 19, 2020, and Sept 27, 2022, we collected detailed primary unit cost data in six hospitals and four ambulatory health facilities and collected data on patient-incurred costs from 73 trial participants. The primary efficacy endpoint of the main trial, a composite of unfavourable outcomes (death, disease recurrence, treatment failure, early discontinuation of therapy, withdrawal, or loss to follow-up) and clinically important safety outcomes by 72 weeks of follow-up were incorporated into the analysis. Societal perspective cost data and effect outcome data were input into a Markov model to estimate the cost per disability-adjusted life-year (DALY) averted by BPaL-based regimens compared with the standard of care over a 20-year time horizon. We conducted a range of univariate and probabilistic sensitivity analyses to test our findings.


FINDINGS

BPaL-based regimens averted a mean of 1·28 DALYs and saved a mean of US$14 868 (SD 291) per person from the provider perspective compared with standard-of-care regimens over 20 years. Patient-incurred costs were reduced by a mean of $172 (SD 0·84) in BPaL-based regimen groups compared with standard of care. The main cost drivers for both providers and patients were inpatient bed-days; the duration of the inpatient period varied across countries. Varying a range of model parameters affected the degree of cost savings but did not change the finding that BPaL-based regimens are cost-saving compared with standard of care.


INTERPRETATION

This trial-based evidence adds to consistent indications from modelling studies that BPaL-based regimens are cost-saving for both the patient and health system. Urgent implementation of BPaL-based regimens in countries with a high burden of tuberculosis could improve treatment of rifampicin-resistant tuberculosis, reduce pill burden, and free up desperately needed resources within the health system.

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Journal Article > LetterFull Text

Improving access to liposomal amphotericin B worldwide

Lancet Global Health. 1 January 2025; Volume 13 (Issue 1); e25.; DOI:10.1016/S2214-109X(24)00461-3
Flores A, Falci DR
Lancet Global Health. 1 January 2025; Volume 13 (Issue 1); e25.; DOI:10.1016/S2214-109X(24)00461-3
Journal Article > LetterFull Text

Improving access to liposomal amphotericin B worldwide – Authors’ reply

Lancet Global Health. 1 January 2025; Volume 13 (Issue 1); e24.; DOI: 10.1016/S2214-109X(24)00462-5
Lee JSF, Sued O, Ribeiro I, Jarvis JN, Burry J
Lancet Global Health. 1 January 2025; Volume 13 (Issue 1); e24.; DOI: 10.1016/S2214-109X(24)00462-5
Journal Article > ResearchFull Text

Safety of hepatitis E vaccine in pregnancy: an emulated target trial following a mass reactive vaccination campaign in Bentiu internally displaced persons camp, South Sudan

Lancet Global Health. 1 November 2024; Volume 12 (Issue 11); e1881-e1890.; DOI:10.1016/S2214-109X(24)00321-8
Nesbitt RC, Azman AS, Asilaza VK, Edwards JK, Gitahi P,  et al.
Lancet Global Health. 1 November 2024; Volume 12 (Issue 11); e1881-e1890.; DOI:10.1016/S2214-109X(24)00321-8
Journal Article > ReviewFull Text

Paving the way for affordable and equitable liposomal amphotericin B access worldwide

Lancet Global Health. 1 September 2024; Volume 12 (Issue 9); e1552-e1559.; DOI:10.1016/S2214-109X(24)00225-0
Lee JSF, Cohen RM, Khan RA, Burry J, Casas EC,  et al.
Lancet Global Health. 1 September 2024; Volume 12 (Issue 9); e1552-e1559.; DOI:10.1016/S2214-109X(24)00225-0
Journal Article > Short ReportFull Text

Diagnostic yield as an important metric for the evaluation of novel tuberculosis tests: rationale and guidance for future research

Lancet Global Health. 1 July 2024; Volume 12 (Issue 7); e1184-e1191.; DOI:10.1016/S2214-109X(24)00148-7
Broger T, Marx FM, Theron G, Marais BJ, Nicol MP,  et al.
Lancet Global Health. 1 July 2024; Volume 12 (Issue 7); e1184-e1191.; DOI:10.1016/S2214-109X(24)00148-7
Journal Article > CommentaryFull Text

The role of humanitarian actors in global governance for AMR

Lancet Global Health. 1 July 2024; Volume S2214-109X (Issue 24); 00319-X.; DOI:10.1016/S2214-109X(24)00319-X
Naim C, Pokorny J, Uyen A, Shortall C, Farra A,  et al.
Lancet Global Health. 1 July 2024; Volume S2214-109X (Issue 24); 00319-X.; DOI:10.1016/S2214-109X(24)00319-X
Journal Article > CommentaryFull Text

The life-long protective immunity of yellow fever vaccination: time to review?

Lancet Global Health. 1 March 2024; Volume 12 (Issue 3); e352-e353.; DOI:10.1016/S2214-109X(23)00594-6
Juan-Giner A, Hombach J
Lancet Global Health. 1 March 2024; Volume 12 (Issue 3); e352-e353.; DOI:10.1016/S2214-109X(23)00594-6