Cost-effectiveness of Xpert®MTB/RIF in the diagnosis of tuberculosis: pragmatic study.
Cost-effectiveness of Xpert®MTB/RIF in the diagnosis of tuberculosis: pragmatic study.
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DOI：
10.1590/0037-8682-0755-2020
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发表时间：
2021
影响因子：
2
通讯作者：
Kritski A
中科院分区：
文献类型：
--
作者：
Silva SCAD;Vater MC;Ramalho DMP;Almeida IN;Miranda SS;Kritski A
加强研究和创新，建立快速和有效的分子检测网络，以此作为消灭结核病的战略，对于避免延误诊断和根除这一疾病至关重要。我们的目的是评估Xpert®MTB/RIF（Xpert）在参考单位中诊断耐药结核病的成本效益，在有补贴和没有补贴的情况下，以及当前相应的成本调整。 进行分析时，将第6个月随访时的阴性培养或临床改善作为有效性标准。使用两种药敏试验（DST）诊断策略（BactecTMMGITTM 960系统与Xpert）进行比较。计算了成本效益和增量成本效益比，并按美国通货膨胀率（1美元= 5.29雷亚尔）进行了美元校正。 受补贴的Xpert成本最低，为33.48美元（67.52雷亚尔），平均效率增量最高（13.57），因此是一项优势分析。在计算通货膨胀后，平均费用为DST-MGIT = 74.85美元（396.73雷亚尔），Xpert = 37.33美元（197.86雷亚尔）。 Xpert在这些参考单位中诊断TB-DR的成本效益与补贴有关。在没有补贴的情况下，TB-DR中的Xpert不具有成本效益。这一因素揭示了依赖国际组织补贴政策的国家的脆弱性。
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. 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). 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. 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.
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DOI：
10.1097/qai.0000000000001110
发表时间：
2016-09-01
影响因子：
3.6
作者：
Padayatchi, Nesri;Naidu, Naressa;Loveday, Marian
通讯作者：
Loveday, Marian
影响因子：
3.7
作者：
Creswell J;Codlin AJ;Andre E;Micek MA;Bedru A;Carter EJ;Yadav RP;Mosneaga A;Rai B;Banu S;Brouwer M;Blok L;Sahu S;Ditiu L
通讯作者：
Ditiu L
影响因子：
3.7
作者：
Naidoo P;Dunbar R;Lombard C;du Toit E;Caldwell J;Detjen A;Squire SB;Enarson DA;Beyers N
通讯作者：
Beyers N
影响因子：
34.3
作者：
Di Tanna, Gian Luca;Khaki, Ali Raza;Bandason, Tsitsi
通讯作者：
Bandason, Tsitsi
DOI：
10.1183/13993003.00543-2016
发表时间：
2016-08
期刊：
The European respiratory journal
影响因子：
--
作者：
Albert H;Nathavitharana RR;Isaacs C;Pai M;Denkinger CM;Boehme CC
通讯作者：
Boehme CC