%0 Journal Article %A Andrea Pantoja %A Christopher Fitzpatrick %A Anna Vassall %A Karin Weyer %A Katherine Floyd %T Xpert MTB/RIF for diagnosis of tuberculosis and drug-resistant tuberculosis: a cost and affordability analysis %D 2013 %R 10.1183/09031936.00147912 %J European Respiratory Journal %P 708-720 %V 42 %N 3 %X 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, of two strategies for diagnosing TB and multidrug-resistant (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$70–90 million per year globally and be lower cost than conventional diagnostics globally and in all high-burden countries. Diagnosing TB in HIV-positive people using Xpert would also cost US$90–101 million per year and be lower cost than conventional diagnostics globally and in 33 out of 36 high-burden countries. Testing everyone with TB signs and symptoms would cost US$434–468 million per 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.Use of Xpert for diagnosis of MDR-TB and TB in HIV-positive people is financially viable and justified globally http://ow.ly/mzPsv %U https://erj.ersjournals.com/content/erj/42/3/708.full.pdf