Application Opens: 2013-10-13
Application Closes: 2013-11-10 at midnight GMT
Summary of funding available across the four research questions
Applications are invited for funding to support work on any of four research questions identified at the recent TB MAC meeting on ‘Modelling to support rational introduction of new drugs and regimens’. Two awards of US$72,500 are available (ie the total funds available across all four research questions = US$145,000).
Title: Modelling to support rational introduction of new drugs and regimens
Reference: TB MAC RFA 3
Duration: Up to 9 months
Funds available: US$145,000 in total across all four research questions
Number of awards available: 2 (Two awards of US$72,500)
Submission opening date: Oct 13th 2013
Submission closing date: Nov 10th 2013
Decisions announced: Dec 9th 2013
Contact: Olivia Ross-Hurst
Details of research question #3: Assessing the health outcomes and economic consequences of different strategies for scale-up of novel regimens

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.

Work Required
The modelling should focus on the use of one or more regimens/drugs likely to be available in next 5 years (Bedaquiline, fluoroquinolone-based regimens, PaMZ) and should investigate roll-out strategies of larger/more rapid versus smaller/slower scope. The model should be calibrated to one or more specific settings and not focus purely on outcomes over the very-long term (i.e., should report outcomes within 20 years as a primary result). Depending on the setting(s) selected, examples of useful comparisons might include (but are not limited to):
– 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

To assess the health outcomes and economic consequences of different strategies for the roll-out of novel TB regimens
1. To identify a range of strategies for the roll-out of novel TB regimens in one or more key settings.
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
1) One manuscript (5-20 pages):
i) draft submitted to TB MAC by grant end date
ii) submitted for publication to an international peer-reviewed scientific journal by grant end date + 3 months
2) One presentation (15-30 slides):
i) submitted to TB MAC by the grant end date, and
ii) presented at a TB MAC or other international meeting/conference by grant end date + 6 months.
3) Policy brief (3-5 pages written for a lay audience)
A contract will be issued from LSHTM either to an institution or to an applicant personally in the form of consultancy fees.
Standard terms
Work done with and for TB MAC is subject to a standard set of terms that require information sharing between all groups working within TB MAC. A full set of terms is available on request.
Members of the TB MAC Secretariat and Advisory Panel are not eligible for this award.
Applications should include a proposal limited to three pages (excluding references, and with a minimum of 11 point font size). Proposals should include: (i) an introduction to the topic; (ii) description of previous work in the area by the applicants; (iii) description and justification of the intended approach; (iv) timeline for the proposed work; (v) budget and its justification. In addition, the principal applicant should provide a separate short bio-sketch (one page summary of qualifications, research interests, key funding publications and major sources of research support).
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