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Modelling to support rational introduction of new drugs and regimens. Research question #1 of 4: What is the optimal allocation of a limited resource to the control of MDR TB? (CLOSED)

The effective management of MDR-TB is a high priority for tuberculosis control, but how should limited funds be allocated so as to achieve the best possible outcome? The standard approach to resource allocation, namely cost-effectiveness analysis, does not solve the problem of how to distribute a finite resource among competing priorities -- for instance, the balance of investment in treating drug sensitive and drug resistant TB to minimize MDR-TB. Results from this study would inform the rational use of both present and future drug regimens in preventing and reversing the spread of drug resistance.

This is the first of four research questions identified for potential funding at the recent TB MAC meeting on 'Modelling to support rational introduction of new drugs and regimens'.

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Modelling to support rational introduction of new drugs and regimens. Research Question #2 of 4: Application of models to maximize the probability of success in phase 3 clinical trials of new drug regimens (CLOSED)

The goal of this research project is to develop models to maximize the probability of success in phase 3 clinical trials of new drug regimens. More specifically, as a first step we seek proposals to develop a model that links two or more categories of early experimental or preclinical data to results observed in later development. This could include establishing the link between results in animal models to predict the results of early clinical trials (i.e., 2-week or 8-week trials) or outcomes of late stage clinical develop (i.e., durable cure).

This is the second of four research questions identified for potential funding at the recent TB MAC meeting on 'Modelling to support rational introduction of new drugs and regimens'.

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Modelling to support rational introduction of new drugs and regimens. Research question #3 of 4: Assessing the health outcomes and economic consequences of different strategies for scale-up of novel regimens (CLOSED)

It is anticipated that, in the coming five years, several new TB drugs and regimens will need to be adopted and rolled out at the country level. While there is broad modelling work at the global level examining the impact and economic consequences of new regimens, there has been little examination of the optimal strategy for actually rolling out these regimens. This work aims to fill this gap, by investigating and comparing the health outcomes and economic consequences of expansive vs limited roll-out strategies in a number of settings. As this would be the first work in this area, and data are scarce, this work will be exploratory in nature, and should guide both future data needs and a approach for using modelling to best support early adopters of novel TB regimens.

This is the third of four research questions identified for potential funding at the recent TB MAC meeting on 'Modelling to support rational introduction of new drugs and regimens'.

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Modelling to support rational introduction of new drugs and regimens. Research question #4 of 4: Modelling to Understand the Epidemiological Impact and Market Impact of Harmonized Regimens for MDR-TB (CLOSED)

An urgent need has been identified for a new type of model which includes the dynamic epidemiological effects of treatment harmonization and the market impacts of treatment harmonization with feedback loops to capture the inter-relationships. A combined model is needed that captures the most important features of both the market side and the epidemiological characteristics.

This is the fourth of four research questions identified for potential funding at the recent TB MAC meeting on 'Modelling to support rational introduction of new drugs and regimens'.

 

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Modelling to support the scale-up of TB case detection within countries [CLOSED]

Currently, there is considerable pressure for country-level policy makers to decide if and how to introduce and/or scale-up the use of Xpert within existing TB control programs. In most cases, these decisions are being made without the benefit of formal projections of the probable impact and costs associated with different approaches for improved case detection. Modelled analyses can provide estimates of how much morbidity and mortality can be averted through different implementation policies, and at what cost, would provide valuable information to guide rational decision making.

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