Table 2.
Expected outcomes and cost-effectiveness of rapid diagnostic algorithms in the base-case analysis for a cohort of 10 000 patients.
| Algorithm | Total costs per patient (95% UR) | % TB cases detectedb (95%UR) | TB deaths per cohort | TB deaths averted (95% UR) | DALY’s per patient (95% UR) | DALY’s averted per cohort (95% UR) | ICER cost per DALY averted (95% UR)c |
|---|---|---|---|---|---|---|---|
| ‘Smear’ | $70.76 ($42–$133) | 66% (0.41–0.80) | 1039 (423–1809) | REF | 14.24 (9.2–19.0) | REF | REF |
| ‘Smear/LF-LAM’ | $81.32 ($52–$157) | 81% (0.62–0.91) | 768 (342–1352) | 271 (67–570) | 13.92 (8.84–18.85) | 3191 (782–9446) | $33 ($24–$175) |
| ‘Xpert’ | $98.31 ($66–$181) | 87% (0.73–0.92) | 635 (277–1202) | 404 (137–715) | 13.76 (8.74–18.78) | 4757 (1471–10964) | $58 ($39–$289) |
| ‘Xpert/LF-LAM’ | $104.69 ($69–$187) | 93% (0.81–0.96) | 530 (237–1051) | 508 (170–885) 104 (30–202)a |
13.64 (8.57–18.75) | 5982 (1794–13933) 1225 (311–3088)a |
$57 ($37–$262) $52 ($12–$175)a |
DALY, disability adjusted life year; UR, uncertainty range.
a
Result when compared with the ‘Xpert’ algorithm.
b
Includes clinical diagnosis and empiric TB treatment.
c
In secondary analysis inclusive of annual HIV/ART costs, ICERs comparing to reference ‘Smear’ algorithm were $421.37 per DALY-averted ($200–$752), $446.29 per DALY-averted ($247–$777), $445.09 per DALY-averted ($244–$766) for the ‘Smear/LF-LAM’, ‘Xpert’, and ‘Xpert/LF-LAM’ algorithms, respectively. Comparing ‘Xpert/LF-LAM’ to ‘Xpert’, the ICER was $440.41 per DALY-averted ($187–$742).