No DST | Solid DST | Rapid RIF | Rapid INH&RIF | |||||
Pre-treatment | 2 months | 3 months | 5 months fail only | 5 months fail+relapse | ||||
Total outcomes per 1000 new TB cases | ||||||||
Total cost | 918732 | 1073370 | 1057742 | 1053939 | 1047829 | 1043442 | 1037331 | 1038773 |
Total DALYs | 52357 | 52493 | 52506 | 52539 | 52518 | 52510 | 52499 | 52509 |
Total deaths (MDR and non-MDR) | 43.1 | 41.1 | 40.0 | 39.1 | 40.3 | 40.8 | 42.0 | 42.0 |
Total MDR cases (MDR cure+relapse¶+fail+die) | 24.1 | 23.9 | 24.1 | 22.3 | 23.1 | 23.4 | 24.0 | 23.9 |
Effectiveness indicators+ | ||||||||
DALYs gained | 136 | 149 | 182 | 161 | 153 | 142 | 152 | |
Deaths averted | 2.0 | 3.5 | 4.0 | 2.8 | 2.2 | 1.2 | 1.2 | |
MDR cases averted | 0.3 | 0.0 | 1.8 | 1.0 | 0.8 | 0.1 | 0.3 | |
Incremental cost-effectiveness ratios+ | ||||||||
Incremental cost | 154637 | 139010 | 135207 | 129096 | 124710 | 118598 | 120041 | |
Incremental cost per DALY gained | 1135 | 935 | 744 | 800 | 816 | 838 | 790 | |
Incremental cost per death averted | 77153 | 40100 | 34218 | 46678 | 56120 | 101012 | 98475 | |
Incremental cost per MDR case averted | 625556 | § | 75972 | 127076 | 162446 | 1021517 | 479779 |
All costs are given in US dollars. RIF: rifampicin; INH: isoniazid; TB: tuberculosis; DALY: disability-adjusted life year; MDR: multidrug resistant. #: non-MDR INH resistance of 5.8% and MDR of 2.1%; no HIV; assumes 100% sensitivity and 100% specificity of all DSTs. ¶: relapse after cure; patients who were cured represent permanent cures without relapse. +: versus no DST. §: incremental cost per MDR case averted not reported because a tiny fraction of an MDR case is averted with rapid RIF scenario, making the cost per case averted extremely large.