Rationale

Computational and mathematical modeling approaches have advanced efforts to end TB through generating evidence-based data to inform research prioritization and public health decision-making. Thus, modeling has been used to estimate the health impact of new vaccines, drugs, diagnostics, and their combinations. While these models were based on the best available estimates at the time, they relied on now out-of-date assumptions on TB natural history and intervention characteristics, resulting in inaccurate estimates of their impact. In addition, they did not estimate cost-effectiveness and budgetary impact, which are critical for decision-makers. Modeling studies have advanced considerably over the last fifteen years, allowing adjustment of assumptions and simulations for generation of more refined estimates. 

Goals and Objective

The goal of PACE is to develop dynamic population and cost-effectiveness models to better understand and predict the impact of various interventions including novel treatment regimens, diagnostic strategies, and prevention modalities based on modern data, to systematically investigate their impact on global TB burden, including populations affected by HIV. 

The specific objectives of PACE are to: 

  1. Update high-level estimates from classic papers using cutting edge TB natural history data to estimate the relative impact and cost-effectiveness of new TB directed interventions, and their optimal combination. 
  2. Estimate the public health impact and cost-effectiveness of novel short course treatment regimens and provide a menu of outcomes to inform decision-making. 
  3. Prioritize research goals for greatest public health impact and address modeling needs across FAST-TB. 

Expected Outcome

PACE aims to collate and analyze the latest natural history data and apply state-of-the-art mathematical models to estimate the relative impact and cost-effectiveness of new interventions and their optimal combinations. FAST-TB partners and stakeholders will use the generated data and estimates in their evidence-based decision making, particularly for new TB treatments. Findings will be disseminated to ensure rapid actions at the global and country level.