Cost-effectiveness of the Xpert® MTB/RIF assay for tuberculosis diagnosis in Brazil.
Int J Tuberc Lung Dis
; 20(5): 611-8, 2016 May.
Article
em En
| MEDLINE
| ID: mdl-27084814
INTRODUCTION: The Xpert® MTB/RIF assay is being implemented as a substitute for sputum smear microscopy (SSM) in many low and high tuberculosis (TB) burden countries, including Brazil, a country with low multidrug resistance and moderate human immunodeficiency virus co-infection rates. SETTING: Brazilian National TB Programme (NTP). OBJECTIVE AND DESIGN: We estimated the incremental cost-effectiveness ratio (ICER) of Xpert as a substitute for two SSM tests in the diagnosis of drug-susceptible TB. The costs for confirming each additional case and for avoiding treatment due to false-positive empirical diagnoses were estimated. RESULTS: The ICER was US$943 for each additional TB diagnosis and US$356 for each additional TB diagnosis with bacteriological confirmation, assuming 80% specificity of clinical diagnosis using both strategies. For every 100 000 patients with suspected TB, the NTP would spend an additional US$1.2 million per year to confirm 3344 more TB patients. The model was highly sensitive to specificity of clinical diagnosis after a negative test. CONCLUSION: Although the NTP has no threshold for cost-effectiveness, our model can provide support for decision makers in Brazil and other countries with a low prevalence of drug resistance among TB patients. Financial benefit can potentially be expected if physicians rely more on a negative Xpert result and empirical treatment is reduced.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Tuberculose Pulmonar
/
DNA Bacteriano
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Reação em Cadeia da Polimerase
/
Custos de Cuidados de Saúde
/
Técnicas de Diagnóstico Molecular
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Farmacorresistência Bacteriana
/
Pulmão
/
Mycobacterium tuberculosis
Tipo de estudo:
Diagnostic_studies
/
Health_economic_evaluation
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
País/Região como assunto:
America do sul
/
Brasil
Idioma:
En
Revista:
Int J Tuberc Lung Dis
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Brasil
País de publicação:
França