TABLE 5.
Costs, outcomes, and cost-effectiveness for different test strategiesa
| Strategy and test | Cost/1,000 patients screened |
No. of patients diagnosed/1,000 screenedb | Cost-effectiveness |
|||
|---|---|---|---|---|---|---|
| Total | Diagnostic | Treatment | Cost per patient diagnosedc | Cost difference (compared to Xpert only) | ||
| Single | ||||||
| Xpert | 355,358 (353,256–359,086) | 14,375 (14,375–14,375) | 340,983 (338,881–344,711) | 237.1 (214.9–256.7) | 1,500 (1,399–1,645) | |
| LAM | 305,927 (305,271–307,949) | 3,557 (3,557–3,557) | 302,370 (303,714–304,392) | 121.3 (98.4,145.4) | 2,525 (2,120–3,124) | 1,025 |
| Sequential | ||||||
| LAM in Xpert-negative patients | 400,656 (412,366–406,317) | 15,049 (14,997–15,014) | 385,608 (397,370–391,303) | 247.9 (205.7–288.6) | 1,617 (1,429–1,976) | 117 |
| Xpert in LAM-negative patients | 401,476 (405,139–414,150) | 16,978 (16,954–16,991) | 384,499 (388,185–397,160) | 247.7 (219–278.1) | 1,621 (1,458–1,892) | 122 |
| Concurrent (Xpert+LAM) | 402,909 (400,992–406,859) | 17,932 17,932–17,932) | 384,977 (383,061–388,927) | 247.9 (226.3–266.3) | 1,626 (1,507–1,799) | 127 |
a
Costs, outcomes, and cost-effectiveness for single, sequential, and concurrent test strategies to diagnose TB in hospitalized patients with advanced HIV using Xpert MTB/RIF and LAM urine tests. Costs are expressed in 2018 U.S. dollars, with 95% CIs in parentheses.
b
Number of culture-positive patients correctly diagnosed and started on treatment per 1,000 patients screened, with 95% CI in parentheses.
c
Cost per culture-positive patient diagnosed and started on treatment.