Higher cost of implementing Xpert(®) MTB/RIF in Ugandan peripheral settings: implications for cost-effectiveness.
Higher cost of implementing Xpert(®) MTB/RIF in Ugandan peripheral settings: implications for cost-effectiveness.
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DOI：
10.5588/ijtld.16.0200
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发表时间：
2016-09
期刊：
影响因子：
--
通讯作者：
Dowdy D
中科院分区：
文献类型：
--
作者：
Hsiang E;Little KM;Haguma P;Hanrahan CF;Katamba A;Cattamanchi A;Davis JL;Vassall A;Dowdy D
Initial cost-effectiveness evaluations of Xpert MTB/RIF (Xpert) for tuberculosis (TB) diagnosis have not fully accounted for realities of implementation in peripheral settings. We evaluated costs and diagnostic outcomes of Xpert testing implemented at various healthcare levels in Uganda. We collected empirical cost data from five health centers utilizing Xpert for TB diagnosis, employing an ingredients approach. We reviewed laboratory and patient records to assess outcomes in these sites and ten sites without Xpert. We also estimated incremental cost-effectiveness of Xpert testing; our primary outcome was incremental cost of Xpert testing per newly detected TB case. The mean unit cost of an Xpert test was US$21 based on a mean monthly volume of 54 tests per site, though unit cost varied widely (US$16–58) and was primarily determined by testing volume. Total diagnostic costs were 2.4-fold higher in Xpert clinics compared to non-Xpert clinics, though Xpert only increased diagnoses by 12%. Diagnostic costs of Xpert averaged US$119 per newly detected TB case but were as high as US$885 in the lowest-volume center. Xpert testing can detect TB cases at reasonable cost but may double diagnostic budgets for relatively small gains, with cost-effectiveness deteriorating with lower testing volumes.
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影响因子：
6.4
作者：
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通讯作者：
Schito, Marco
影响因子：
3.7
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15.8
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影响因子：
24.3
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通讯作者：
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