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.
– Staging or speed of implementation (high [“disseminate immediately”] vs. low [“pilot first”] initial coverage)
– Channel of delivery (for example, rapid vs. measured engagement with private sector)
– Placement in the health system (for example, centralized vs. decentralized)
– Target patient groups (broad vs. narrow indication)The modelling should also assess the consequences of their analysis for future data needs and modelling support in the selected setting(s), including the data that would be most important to obtain in order to improve the decision-making process.
Applicants may also wish to assess wider economic or epidemiological issues that might be important to decision makers, such as:
– Economic consequences in the form of budget impact as well as cost-effectiveness
– The optimal balance between short term gains (e.g., increased risk of losing drugs/regimens to resistance if rolled out too quickly in an expensive strategy) vs longer term risks in areas (in terms of flexibility for future regimens)
– Equity implications of different roll-out strategies
2. To develop a framework for assessing the short and long term health outcomes and economic consequences of the selected strategies.
3. To inform practical decision-making about the roll-out of novel TB regimens in one or more key settings.
4. To identify the most important data gaps that currently limit decision-making ability related to roll-out of novel TB regimens.
5. To disseminate findings to key stakeholders involved in rolling out new TB drug regimens in the selected setting(s).
Assessment criteriaAll applications will be reviewed by expert reviewers. All applications to this research question will be scored against the following criteria:
- Is the research question and plan well-described
- Is the research team qualified to conduct this research
- Is the budget and timeline appropriate for the proposed activity
- Is the proposal likely to meet the aim and objectives outlined in the RFA
- Is the dissemination and impact maximisation plan adequate
- Does the proposal explain how models and data will be shared for maximum public utility
- Does the proposal demonstrate a sound knowledge of the alternative strategies to be considered and their likely health outcomes and economic consequences
- Does the proposal demonstrate a high quality modelling and economic approach
- Does the proposal explain clearly how collaboration with both global and national stakeholders will be achieved
- Have sufficient expertise to conduct the proposed analysis