PT  - JOURNAL ARTICLE
AU  - Pantoja, Andrea
AU  - Fitzpatrick, Christopher
AU  - Vassall, Anna
AU  - Weyer, Karin
AU  - Floyd, Katherine
TI  - Xpert MTB/RIF for diagnosis of tuberculosis and drug-resistant tuberculosis: a cost and affordability analysis
AID  - 10.1183/09031936.00147912
DP  - 2013 Sep 01
TA  - European Respiratory Journal
PG  - 708--720
VI  - 42
IP  - 3
4099  - http://erj.ersjournals.com/content/42/3/708.short
4100  - http://erj.ersjournals.com/content/42/3/708.full
SO  - Eur Respir J2013 Sep 01; 42
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, 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