Table 5– Total outcomes, effectiveness indicators and incremental cost-effectiveness ratios (versus no drug susceptibility test (DST)) for a moderate drug resistance setting with high HIV#
No DSTSolid DSTRapid RIFRapid INH&RIF
Pre-treatment2 months3 months5 months fail only5 months fail+relapse
Total outcomes per 1000 new TB cases
 Total cost8551031009250968311965052989026980317963945965129
 Total DALYs5104451159511735120451180511695115451161
 Total deaths (MDR and non-MDR)123.6112.0118.8117.7119.1119.7120.8120.7
 Total MDR cases (MDR cure+relapse++fail+die)23.823.523.822.122.722.923.523.4
Effectiveness indicators§
 DALYs gained115129160136125110117
 Deaths averted3.64.85.84.63.92.82.9
 MDR cases averted0.20.01.61.10.80.20.3
Incremental cost-effectiveness ratios§
 Incremental cost154147113208109949133923125214108842110026
 Incremental cost per DALY gained1343880687987999987939
 Incremental cost per death averted43106236921882530007325043913538538
 Incremental cost per MDR case averted71530168598127570152737461196324369
  • 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.