Table 2. Total cohort cost, DALYS, cost per DALY and ICER for Xpert on all compared to triage pathways as the base case.
Country | Algorithm and scenarios | Total Costs ($2011) | Incremental Costs | Total DALYS | Incremental DALYs averted | Cost per DALY averted | ICER of Xpert-forall, compared to the triage pathway example | Monte Carlo Simulation ICER, Median (2.5, 97.5)* |
Uganda | Triage; if positive followed by Xpert. | |||||||
Example 2. 95% sensitivity, 75% specificity, cost $5 | 309250 | 12102 | 26 | base case | ||||
Xpert for all persons with presumptive TB | 408895 | 99646 | 12306 | 203 | 33 | 491 | 487 (392, 597) | |
Example 3. 85% sensitivity, 85% specificity, cost $5 | 280460 | 11566 | 24 | base case | ||||
Xpert for all persons with presumptive TB | 408895 | 128436 | 12306 | 740 | 33 | 174 | 173 (144, 206) | |
India | Triage; if positive followed by Xpert. | |||||||
Example 2. 95% sensitivity, 75% specificity, cost $5 | 345754 | 9904 | 35 | base case | ||||
Xpert for all persons with presumptive TB | 415720 | 69966 | 10009 | 106 | 42 | 662 | 672 (541, 833) | |
Example 3. 85% sensitivity, 85% specificity, cost $5 | 321493 | 9568 | 34 | base case | ||||
Xpert for all persons with presumptive TB | 415720 | 94228 | 10009 | 442 | 42 | 213 | 216 (179, 260) | |
South Africa | Triage; if positive followed by Xpert. | |||||||
Example 2. 95% sensitivity, 75% specificity, cost $5 | 864481 | 10176 | 85 | base case | ||||
Xpert for all persons with presumptive TB | 985767 | 121286 | 10351 | 175 | 95 | 695 | 695 (575, 836) | |
Example 3. 85% sensitivity, 85% specificity, cost $5 | 807940 | 9719 | 83 | base case | ||||
Xpert for all persons with presumptive TB | 985767 | 177827 | 10351 | 632 | 95 | 281 | 282 (240, 330) |
% prevalence of smear-positive TB. For a cohort of 10 000 persons with presumptive TB with 5
= incremental cost-effectiveness ratio. ICER
= disability adjusted life year. DALY
= multi-drug resistant. MDR
= GeneXpert MTB/RIF assay. Xpert
Fixed values for the sensitivity, specificity and cost of the triage test.