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-effectivene...
Published in: | Revista da Sociedade Brasileira de Medicina Tropical |
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Sociedade Brasileira de Medicina Tropical (SBMT)
2021
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Online Access: | https://doi.org/10.1590/0037-8682-0755-2020 https://doaj.org/article/d6ef3f7a1a564c96a91f347c6e14b9ea |
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ftdoajarticles:oai:doaj.org/article:d6ef3f7a1a564c96a91f347c6e14b9ea 2023-05-15T15:09:46+02:00 Cost-effectiveness of Xpert®MTB/RIF in the diagnosis of tuberculosis: pragmatic study Suely Conceição Alves da Silva Maria Claudia Vater Daniela Maria de Paula Ramalho Isabela Neves de Almeida Silvana Spíndola de Miranda Afrânio Kritski 2021-02-01T00:00:00Z https://doi.org/10.1590/0037-8682-0755-2020 https://doaj.org/article/d6ef3f7a1a564c96a91f347c6e14b9ea EN eng Sociedade Brasileira de Medicina Tropical (SBMT) http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822021000100311&tlng=en https://doaj.org/toc/1678-9849 1678-9849 doi:10.1590/0037-8682-0755-2020 https://doaj.org/article/d6ef3f7a1a564c96a91f347c6e14b9ea Revista da Sociedade Brasileira de Medicina Tropical, Vol 54 (2021) Multidrug-resistant tuberculosis Cost-effectiveness New diagnostics Xpert MTB/RIF Innovation Arctic medicine. Tropical medicine RC955-962 article 2021 ftdoajarticles https://doi.org/10.1590/0037-8682-0755-2020 2022-12-31T02:47:39Z 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. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Rif ENVELOPE(-16.172,-16.172,66.526,66.526) Revista da Sociedade Brasileira de Medicina Tropical 54 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Multidrug-resistant tuberculosis Cost-effectiveness New diagnostics Xpert MTB/RIF Innovation Arctic medicine. Tropical medicine RC955-962 |
spellingShingle |
Multidrug-resistant tuberculosis Cost-effectiveness New diagnostics Xpert MTB/RIF Innovation Arctic medicine. Tropical medicine RC955-962 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 |
topic_facet |
Multidrug-resistant tuberculosis Cost-effectiveness New diagnostics Xpert MTB/RIF Innovation Arctic medicine. Tropical medicine RC955-962 |
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. |
format |
Article in Journal/Newspaper |
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 |
title |
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_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_sort |
cost-effectiveness of xpert®mtb/rif in the diagnosis of tuberculosis: pragmatic study |
publisher |
Sociedade Brasileira de Medicina Tropical (SBMT) |
publishDate |
2021 |
url |
https://doi.org/10.1590/0037-8682-0755-2020 https://doaj.org/article/d6ef3f7a1a564c96a91f347c6e14b9ea |
long_lat |
ENVELOPE(-16.172,-16.172,66.526,66.526) |
geographic |
Arctic Rif |
geographic_facet |
Arctic Rif |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Revista da Sociedade Brasileira de Medicina Tropical, Vol 54 (2021) |
op_relation |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822021000100311&tlng=en https://doaj.org/toc/1678-9849 1678-9849 doi:10.1590/0037-8682-0755-2020 https://doaj.org/article/d6ef3f7a1a564c96a91f347c6e14b9ea |
op_doi |
https://doi.org/10.1590/0037-8682-0755-2020 |
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Revista da Sociedade Brasileira de Medicina Tropical |
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54 |
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