Cost-effectiveness of Xpert®MTB/RIF in the diagnosis of tuberculosis : pragmatic study.
No Thumbnail Available
Date
2021
Authors
Silva, Suely Conceição Alves da
Vater, Maria Cláudia
Ramalho, Daniela Maria de Paula
Almeida, Isabela Neves de
Miranda, Silvana Spíndola de
Kritski, Afrânio Lineu
Journal Title
Journal ISSN
Volume Title
Publisher
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.
Description
Keywords
Multidrug‑resistant tuberculosis, New diagnostics, Innovation
Citation
SILVA, S. C. A. da et al. Cost-effectiveness of Xpert®MTB/RIF in the diagnosis of tuberculosis: pragmatic study. Revista da Sociedade Brasileira de Medicina Tropical, v. 54, artigo e07552020-58, 2021. Disponível em: <https://www.scielo.br/j/rsbmt/a/bYTYxJ6jMrskQjjV5v5TkDR/?lang=en#:~:text=RESULTS%3A,%24197%2C86)%20with%20subsidies.>. Acesso em: 11 out. 2022.