Cost-effectiveness of Xpert®MTB/RIF in the diagnosis of tuberculosis: pragmatic study
Abstract INTRODUCTION: The intensification of research and innovation with the creation of networks of rapid and effective molecular tests as strategies for the end of tuberculosis are essential to avoid late diagnosis and for the eradication of the disease. We aimed to evaluate the cost-effective...
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Sociedade Brasileira de Medicina Tropical (SBMT)
2021-02-01
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| Series: | Revista da Sociedade Brasileira de Medicina Tropical |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822021000100311&tlng=en |
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| author | Suely Conceição Alves da Silva Maria Claudia Vater Daniela Maria de Paula Ramalho Isabela Neves de Almeida Silvana Spíndola de Miranda Afrânio Kritski |
| author_facet | Suely Conceição Alves da Silva Maria Claudia Vater Daniela Maria de Paula Ramalho Isabela Neves de Almeida Silvana Spíndola de Miranda Afrânio Kritski |
| author_sort | Suely Conceição Alves da Silva |
| collection | DOAJ |
| description | Abstract INTRODUCTION: The intensification of research and innovation with the creation of networks of rapid and effective molecular tests as strategies for the end of tuberculosis are essential to avoid late diagnosis and for the eradication of the disease. We aimed to evaluate the cost-effectiveness of Xpert®MTB/RIF (Xpert) in the diagnosis of drug-resistant tuberculosis in reference units, in scenarios with and without subsidies, and the respective cost adjustment for today. METHODS: The analyses were performed considering as criterion of effectiveness, negative culture or clinical improvement in the sixth month of follow-up. The comparison was performed using two diagnostic strategies for the drug susceptibility test (DST), BactecTMMGITTM960 System, versus Xpert. The cost effectiveness and incremental cost-effectiveness ratio (ICER) were calculated and dollar-corrected for American inflation (US$ 1.00 = R$ 5,29). RESULTS: Subsidized Xpert had the lowest cost of US$ 33.48 (R$67,52) and the highest incremental average efficiency (13.57), thus being a dominated analysis. After the inflation was calculated, the mean cost was DST-MGIT=US$ 74.85 (R$ 396,73) and Xpert = US$ 37.33 (R$197,86) with subsidies. CONCLUSIONS: The Xpert in the diagnosis of TB-DR in these reference units was cost-effective with subsidies. In the absence of a subsidy, Xpert in TB-DR is not characterized as cost effective. This factor reveals the vulnerability of countries dependent on international organizations’ subsidy policies. |
| first_indexed | 2024-12-12T08:22:20Z |
| format | Article |
| id | doaj.art-d6ef3f7a1a564c96a91f347c6e14b9ea |
| institution | Directory Open Access Journal |
| issn | 1678-9849 |
| language | English |
| last_indexed | 2024-12-12T08:22:20Z |
| publishDate | 2021-02-01 |
| publisher | Sociedade Brasileira de Medicina Tropical (SBMT) |
| record_format | Article |
| series | Revista da Sociedade Brasileira de Medicina Tropical |
| spelling | doaj.art-d6ef3f7a1a564c96a91f347c6e14b9ea2022-12-22T00:31:22ZengSociedade Brasileira de Medicina Tropical (SBMT)Revista da Sociedade Brasileira de Medicina Tropical1678-98492021-02-015410.1590/0037-8682-0755-2020Cost-effectiveness of Xpert®MTB/RIF in the diagnosis of tuberculosis: pragmatic studySuely Conceição Alves da SilvaMaria Claudia VaterDaniela Maria de Paula RamalhoIsabela Neves de AlmeidaSilvana Spíndola de Mirandahttps://orcid.org/0000-0001-7245-4472Afrânio KritskiAbstract INTRODUCTION: The intensification of research and innovation with the creation of networks of rapid and effective molecular tests as strategies for the end of tuberculosis are essential to avoid late diagnosis and for the eradication of the disease. We aimed to evaluate the cost-effectiveness of Xpert®MTB/RIF (Xpert) in the diagnosis of drug-resistant tuberculosis in reference units, in scenarios with and without subsidies, and the respective cost adjustment for today. METHODS: The analyses were performed considering as criterion of effectiveness, negative culture or clinical improvement in the sixth month of follow-up. The comparison was performed using two diagnostic strategies for the drug susceptibility test (DST), BactecTMMGITTM960 System, versus Xpert. The cost effectiveness and incremental cost-effectiveness ratio (ICER) were calculated and dollar-corrected for American inflation (US$ 1.00 = R$ 5,29). RESULTS: Subsidized Xpert had the lowest cost of US$ 33.48 (R$67,52) and the highest incremental average efficiency (13.57), thus being a dominated analysis. After the inflation was calculated, the mean cost was DST-MGIT=US$ 74.85 (R$ 396,73) and Xpert = US$ 37.33 (R$197,86) with subsidies. CONCLUSIONS: The Xpert in the diagnosis of TB-DR in these reference units was cost-effective with subsidies. In the absence of a subsidy, Xpert in TB-DR is not characterized as cost effective. This factor reveals the vulnerability of countries dependent on international organizations’ subsidy policies.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822021000100311&tlng=enMultidrug-resistant tuberculosisCost-effectivenessNew diagnosticsXpert MTB/RIFInnovation |
| spellingShingle | Suely Conceição Alves da Silva Maria Claudia Vater Daniela Maria de Paula Ramalho Isabela Neves de Almeida Silvana Spíndola de Miranda Afrânio Kritski Cost-effectiveness of Xpert®MTB/RIF in the diagnosis of tuberculosis: pragmatic study Revista da Sociedade Brasileira de Medicina Tropical Multidrug-resistant tuberculosis Cost-effectiveness New diagnostics Xpert MTB/RIF Innovation |
| title | Cost-effectiveness of Xpert®MTB/RIF in the diagnosis of tuberculosis: pragmatic study |
| title_full | Cost-effectiveness of Xpert®MTB/RIF in the diagnosis of tuberculosis: pragmatic study |
| title_fullStr | Cost-effectiveness of Xpert®MTB/RIF in the diagnosis of tuberculosis: pragmatic study |
| title_full_unstemmed | Cost-effectiveness of Xpert®MTB/RIF in the diagnosis of tuberculosis: pragmatic study |
| title_short | Cost-effectiveness of Xpert®MTB/RIF in the diagnosis of tuberculosis: pragmatic study |
| title_sort | cost effectiveness of xpert r mtb rif in the diagnosis of tuberculosis pragmatic study |
| topic | Multidrug-resistant tuberculosis Cost-effectiveness New diagnostics Xpert MTB/RIF Innovation |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822021000100311&tlng=en |
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