Imperial College London

Jeff Eaton

Faculty of MedicineSchool of Public Health

Senior Lecturer in HIV Epidemiology







Norfolk PlaceSt Mary's Campus






BibTex format

author = {Menzies, NA and Gomez, GB and Bozzani, F and Chatterjee, S and Foster, N and Baena, IG and Laurence, YV and Qiang, S and Siroka, A and Sweeney, S and Verguet, S and Arinaminpathy, N and Azman, AS and Bendavid, E and Chang, ST and Cohen, T and Denholm, JT and Dowdy, DW and Eckhoff, PA and Goldhaber-Fiebert, JD and Handel, A and Huynh, GH and Lalli, M and Lin, HH and Mandal, S and McBryde, ES and Pandey, S and Salomon, JA and Suen, SC and Sumner, T and Trauer, JM and Wagner, BG and Whalen, CC and Wu, CY and Boccia, D and Chadha, VK and Charalambous, S and Chin, DP and Churchyard, G and Daniels, C and Dewan, P and Ditiu, L and Eaton, JW and Grant, AD and Hippner, P and Hosseini, M and Mametja, D and Pretorius, C and Pillay, Y and Rade, K and Sahu, S and Wang, L and Houben, RM and Kimerling, ME and White, RG and Vassall, A},
doi = {10.1016/S2214-109X(16)30265-0},
journal = {Lancet Global Health},
pages = {e816--e826},
title = {Cost-effectiveness and resource implications of aggressive action on tuberculosis in China, India, and South Africa: a combined analysis of nine models},
url = {},
volume = {4},
year = {2016}

RIS format (EndNote, RefMan)

AB - BACKGROUND: The post-2015 End TB Strategy sets global targets of reducing tuberculosis incidence by 50% and mortality by 75% by 2025. We aimed to assess resource requirements and cost-effectiveness of strategies to achieve these targets in China, India, and South Africa. METHODS: We examined intervention scenarios developed in consultation with country stakeholders, which scaled up existing interventions to high but feasible coverage by 2025. Nine independent modelling groups collaborated to estimate policy outcomes, and we estimated the cost of each scenario by synthesising service use estimates, empirical cost data, and expert opinion on implementation strategies. We estimated health effects (ie, disability-adjusted life-years averted) and resource implications for 2016-35, including patient-incurred costs. To assess resource requirements and cost-effectiveness, we compared scenarios with a base case representing continued current practice. FINDINGS: Incremental tuberculosis service costs differed by scenario and country, and in some cases they more than doubled existing funding needs. In general, expansion of tuberculosis services substantially reduced patient-incurred costs and, in India and China, produced net cost savings for most interventions under a societal perspective. In all three countries, expansion of access to care produced substantial health gains. Compared with current practice and conventional cost-effectiveness thresholds, most intervention approaches seemed highly cost-effective. INTERPRETATION: Expansion of tuberculosis services seems cost-effective for high-burden countries and could generate substantial health and economic benefits for patients, although substantial new funding would be required. Further work to determine the optimal intervention mix for each country is necessary. FUNDING: Bill & Melinda Gates Foundation.
AU - Menzies,NA
AU - Gomez,GB
AU - Bozzani,F
AU - Chatterjee,S
AU - Foster,N
AU - Baena,IG
AU - Laurence,YV
AU - Qiang,S
AU - Siroka,A
AU - Sweeney,S
AU - Verguet,S
AU - Arinaminpathy,N
AU - Azman,AS
AU - Bendavid,E
AU - Chang,ST
AU - Cohen,T
AU - Denholm,JT
AU - Dowdy,DW
AU - Eckhoff,PA
AU - Goldhaber-Fiebert,JD
AU - Handel,A
AU - Huynh,GH
AU - Lalli,M
AU - Lin,HH
AU - Mandal,S
AU - McBryde,ES
AU - Pandey,S
AU - Salomon,JA
AU - Suen,SC
AU - Sumner,T
AU - Trauer,JM
AU - Wagner,BG
AU - Whalen,CC
AU - Wu,CY
AU - Boccia,D
AU - Chadha,VK
AU - Charalambous,S
AU - Chin,DP
AU - Churchyard,G
AU - Daniels,C
AU - Dewan,P
AU - Ditiu,L
AU - Eaton,JW
AU - Grant,AD
AU - Hippner,P
AU - Hosseini,M
AU - Mametja,D
AU - Pretorius,C
AU - Pillay,Y
AU - Rade,K
AU - Sahu,S
AU - Wang,L
AU - Houben,RM
AU - Kimerling,ME
AU - White,RG
AU - Vassall,A
DO - 10.1016/S2214-109X(16)30265-0
EP - 826
PY - 2016///
SN - 2214-109X
SP - 816
TI - Cost-effectiveness and resource implications of aggressive action on tuberculosis in China, India, and South Africa: a combined analysis of nine models
T2 - Lancet Global Health
UR -
UR -
VL - 4
ER -