RT Journal Article
SR Electronic
T1 Xpert MTB/RIF for diagnosis of TB and drug-resistant TB: a cost and affordability analysis
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP erj01479-2012
DO 10.1183/09031936.00147912
A1 Andrea Pantoja
A1 Christopher Fitzpatrick
A1 Anna Vassall
A1 Karin Weyer
A1 Katherine Floyd
YR 2012
UL http://erj.ersjournals.com/content/early/2012/12/19/09031936.00147912.abstract
AB Xpert MTB/RIF is a rapid test to diagnose tuberculosis (TB) and rifampicin-resistant TB. Cost and affordability will influence its uptake.We assessed the cost, globally and in 36 high-burden countries (HBCs), of two strategies for diagnosing TB and multidrug-resistant TB (MDR-TB): Xpert with follow-on diagnostics, and conventional diagnostics. Costs were compared with funding available for TB care and control, and donor investments in HIV prevention and care.Using Xpert to diagnose MDR-TB would cost US$ 0.09 billion/year globally and be lower cost than conventional diagnostics globally and in all HBCs. Diagnosing TB in HIV-positive people using Xpert would also cost about US$ 0.10 billion/year and be lower cost than conventional diagnostics globally and in 33/36 HBCs. Testing everyone with TB signs and symptoms would cost almost US$ 0.47 billion/year globally, much more than conventional diagnostics. However, in European countries, Brazil and South Africa the cost would represent <10% of TB funding.Introducing Xpert to diagnose MDR-TB and to diagnose TB in HIV-positive people is warranted in many countries. Using it to test everyone with TB signs and symptoms is affordable in several middle-income countries, but financial viability in low-income countries requires large increases in TB funding and/or further price reductions.