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 | 855103 | 1009250 | 968311 | 965052 | 989026 | 980317 | 963945 | 965129 |
Total DALYs¶ | 51044 | 51159 | 51173 | 51204 | 51180 | 51169 | 51154 | 51161 |
Total deaths (MDR and non-MDR) | 123.6 | 112.0 | 118.8 | 117.7 | 119.1 | 119.7 | 120.8 | 120.7 |
Total MDR cases (MDR cure+relapse++fail+die) | 23.8 | 23.5 | 23.8 | 22.1 | 22.7 | 22.9 | 23.5 | 23.4 |
Effectiveness indicators§ | ||||||||
DALYs gained | 115 | 129 | 160 | 136 | 125 | 110 | 117 | |
Deaths averted | 3.6 | 4.8 | 5.8 | 4.6 | 3.9 | 2.8 | 2.9 | |
MDR cases averted | 0.2 | 0.0 | 1.6 | 1.1 | 0.8 | 0.2 | 0.3 | |
Incremental cost-effectiveness ratios§ | ||||||||
Incremental cost | 154147 | 113208 | 109949 | 133923 | 125214 | 108842 | 110026 | |
Incremental cost per DALY gained | 1343 | 880 | 687 | 987 | 999 | 987 | 939 | |
Incremental cost per death averted | 43106 | 23692 | 18825 | 30007 | 32504 | 39135 | 38538 | |
Incremental cost per MDR case averted | 715301 | 68598 | 127570 | 152737 | 461196 | 324369 |
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%; 50% of cases co-infected with HIV; assumes 100% sensitivity and 100% specificity of all DSTs. ¶: DALYs are estimated for TB morbidity and mortality only, and do not account for non-TB effect of HIV. +: relapse after cure; patients who were cured represent permanent cures without relapse. §: versus no DST.