Determining cost and placement decisions for moderate complexity NAATs for tuberculosis drug susceptibility testing.
<h4>Background</h4>Access to drug resistant testing for tuberculosis (TB) remains a challenge in high burden countries. Recently, the World Health Organization approved the use of several moderate complexity automated nucleic acid amplification tests (MC-NAAT) that have performance profi...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2023-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0290496 |
| _version_ | 1797377715180929024 |
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| author | Akash Malhotra Ryan Thompson Margaretha De Vos Anura David Samuel Schumacher Hojoon Sohn |
| author_facet | Akash Malhotra Ryan Thompson Margaretha De Vos Anura David Samuel Schumacher Hojoon Sohn |
| author_sort | Akash Malhotra |
| collection | DOAJ |
| description | <h4>Background</h4>Access to drug resistant testing for tuberculosis (TB) remains a challenge in high burden countries. Recently, the World Health Organization approved the use of several moderate complexity automated nucleic acid amplification tests (MC-NAAT) that have performance profiles suitable for placement in a range of TB laboratory tiers to improve drug susceptibility tests (DST) coverage.<h4>Methods</h4>We conducted cost analysis of two MC-NAATs with different testing throughput: Lower Throughput (LT, < 24 tests per run) and Higher Throughput (HT, upto 90+ tests per run) for placement in a hypothetical laboratory in a resource limited setting. We used per-test cost as the main indicator to assess 1) drivers of cost by resource types and 2) optimized levels of annual testing volumes for the respective MC-NAATs.<h4>Results</h4>The base-case per test cost of $18.52 (range: $13.79 - $40.70) for LT test and $15.37 (range: $9.61 - $37.40) for HT test. Per test cost estimates were most sensitive to the number of testing days per week, followed by equipment costs and TB-specific workloads. In general, HT NAATs were cheaper at all testing volume levels, but at lower testing volumes (less than 2,000 per year) LT tests can be cheaper if the durability of the testing system is markedly better and/or procured equipment costs are lower than that of HT NAAT.<h4>Conclusion</h4>Assuming equivalent performance and infrastructural needs, placement strategies for MC-NAATs need to be prioritized by laboratory system's operational factors, testing demands, and costs. |
| first_indexed | 2024-03-08T19:57:31Z |
| format | Article |
| id | doaj.art-ccf22f7428f944b8b7d24afe471ecc5d |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-03-08T19:57:31Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-ccf22f7428f944b8b7d24afe471ecc5d2023-12-24T05:33:44ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01188e029049610.1371/journal.pone.0290496Determining cost and placement decisions for moderate complexity NAATs for tuberculosis drug susceptibility testing.Akash MalhotraRyan ThompsonMargaretha De VosAnura DavidSamuel SchumacherHojoon Sohn<h4>Background</h4>Access to drug resistant testing for tuberculosis (TB) remains a challenge in high burden countries. Recently, the World Health Organization approved the use of several moderate complexity automated nucleic acid amplification tests (MC-NAAT) that have performance profiles suitable for placement in a range of TB laboratory tiers to improve drug susceptibility tests (DST) coverage.<h4>Methods</h4>We conducted cost analysis of two MC-NAATs with different testing throughput: Lower Throughput (LT, < 24 tests per run) and Higher Throughput (HT, upto 90+ tests per run) for placement in a hypothetical laboratory in a resource limited setting. We used per-test cost as the main indicator to assess 1) drivers of cost by resource types and 2) optimized levels of annual testing volumes for the respective MC-NAATs.<h4>Results</h4>The base-case per test cost of $18.52 (range: $13.79 - $40.70) for LT test and $15.37 (range: $9.61 - $37.40) for HT test. Per test cost estimates were most sensitive to the number of testing days per week, followed by equipment costs and TB-specific workloads. In general, HT NAATs were cheaper at all testing volume levels, but at lower testing volumes (less than 2,000 per year) LT tests can be cheaper if the durability of the testing system is markedly better and/or procured equipment costs are lower than that of HT NAAT.<h4>Conclusion</h4>Assuming equivalent performance and infrastructural needs, placement strategies for MC-NAATs need to be prioritized by laboratory system's operational factors, testing demands, and costs.https://doi.org/10.1371/journal.pone.0290496 |
| spellingShingle | Akash Malhotra Ryan Thompson Margaretha De Vos Anura David Samuel Schumacher Hojoon Sohn Determining cost and placement decisions for moderate complexity NAATs for tuberculosis drug susceptibility testing. PLoS ONE |
| title | Determining cost and placement decisions for moderate complexity NAATs for tuberculosis drug susceptibility testing. |
| title_full | Determining cost and placement decisions for moderate complexity NAATs for tuberculosis drug susceptibility testing. |
| title_fullStr | Determining cost and placement decisions for moderate complexity NAATs for tuberculosis drug susceptibility testing. |
| title_full_unstemmed | Determining cost and placement decisions for moderate complexity NAATs for tuberculosis drug susceptibility testing. |
| title_short | Determining cost and placement decisions for moderate complexity NAATs for tuberculosis drug susceptibility testing. |
| title_sort | determining cost and placement decisions for moderate complexity naats for tuberculosis drug susceptibility testing |
| url | https://doi.org/10.1371/journal.pone.0290496 |
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