Your browser doesn't support javascript.
loading
Cost-effectiveness of the Xpert® MTB/RIF assay for tuberculosis diagnosis in Brazil.
Pinto, M; Steffen, R E; Cobelens, F; van den Hof, S; Entringer, A; Trajman, A.
Afiliação
  • Pinto M; Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
  • Steffen RE; Rio de Janeiro Federal University, Rio de Janeiro, Rio de Janeiro, Brazil.
  • Cobelens F; KNCV Tuberculosis Foundation, The Hague, The Netherlands; Department of Global Health, Academic Medical Center, and Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands.
  • van den Hof S; KNCV Tuberculosis Foundation, The Hague, The Netherlands; Department of Global Health, Academic Medical Center, and Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands.
  • Entringer A; Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
  • Trajman A; Rio de Janeiro Federal University, Rio de Janeiro, Rio de Janeiro, Brazil, McGill University, Montréal, Quebec, Canada.
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.
Assuntos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Tuberculose Pulmonar / DNA Bacteriano / Reação em Cadeia da Polimerase / Custos de Cuidados de Saúde / Técnicas de Diagnóstico Molecular / 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
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Tuberculose Pulmonar / DNA Bacteriano / Reação em Cadeia da Polimerase / Custos de Cuidados de Saúde / Técnicas de Diagnóstico Molecular / 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