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Intention to Treat or per Protocol? Overly Optimistic Findings Regarding the Cost-Effectiveness of 99DOTS, a Tuberculosis Digital Adherence Technology

Published:October 17, 2022DOI:https://doi.org/10.1016/j.jval.2022.09.008
      We read with interest the recent study by Thompson and colleagues,
      • Thompson R.
      • Kityamuwesi A.
      • Kuan A.
      • et al.
      Cost and cost-effectiveness of a digital adherence technology for tuberculosis treatment support in Uganda.
      which evaluated the cost-effectiveness of 99DOTS, a digital adherence technology (DAT). DATs, and 99DOTS in particular, are being increasingly used by national tuberculosis (TB) programs in low- and middle-income countries, with the premise that they may help monitor and support people taking TB therapy. High-quality evidence regarding costs and cost-effectiveness is needed for programs to make informed decisions about whether to invest in DATs, particularly given the competing need to address other complex medical, social, and nutritional needs of people with TB.
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