Skip to content Skip to navigation
University of Warwick
  • Study
  • |
  • Research
  • |
  • Business
  • |
  • Alumni
  • |
  • News
  • |
  • About

University of Warwick
Publications service & WRAP

Highlight your research

  • WRAP
    • Home
    • Search WRAP
    • Browse by Warwick Author
    • Browse WRAP by Year
    • Browse WRAP by Subject
    • Browse WRAP by Department
    • Browse WRAP by Funder
    • Browse Theses by Department
  • Publications Service
    • Home
    • Search Publications Service
    • Browse by Warwick Author
    • Browse Publications service by Year
    • Browse Publications service by Subject
    • Browse Publications service by Department
    • Browse Publications service by Funder
  • Help & Advice
University of Warwick

The Library

  • Login
  • Admin

Comparing laboratory costs of smear/culture and Xpert(®) MTB/RIF-based tuberculosis diagnostic algorithms

Tools
- Tools
+ Tools

Naidoo, P., Dunbar, R., du Toit, E., van Niekerk, M., Squire, S. B., Beyers, N. and Madan, Jason (2016) Comparing laboratory costs of smear/culture and Xpert(®) MTB/RIF-based tuberculosis diagnostic algorithms. The International Journal of Tuberculosis and Lung Disease, 20 (10). pp. 1377-1385. doi:10.5588/ijtld.16.0081 ISSN 1815-7920. [ 🗎 Public].

[img] PDF
WRAP_wms_clinical_trials-110117-r1_laboratory_costs_20160505.pdf - Accepted Version - Requires a PDF viewer.

Download (586Kb)
Official URL: https://doi.org/10.5588/ijtld.16.0081

Request Changes to record.

Abstract

SETTING: Cape Town, South Africa, where Xpert® MTB/RIF was introduced as a screening test for all presumptive tuberculosis (TB) cases.

OBJECTIVE: To compare laboratory costs of smear/culture- and Xpert-based tuberculosis (TB) diagnostic algorithms in routine operational conditions.

METHODS: Economic costing was undertaken from a laboratory perspective, using an ingredients-based costing approach. Cost allocation was based on reviews of standard operating procedures and laboratory records, timing of test procedures, measurement of laboratory areas and manager interviews. We analysed laboratory test data to assess overall costs and cost per pulmonary TB and multidrug-resistant TB (MDR-TB) case diagnosed. Costs were expressed as 2013 Consumer Price Index-adjusted values.

RESULTS: Total TB diagnostic costs increased by 43%, from US$440 967 in the smear/culture-based algorithm (April–June 2011) to US$632 262 in the Xpert-based algorithm (April–June 2013). The cost per TB case diagnosed increased by 157%, from US$48.77 (n = 1601) to US$125.32 (n = 1281). The total cost per MDR-TB case diagnosed was similar, at US$190.14 and US$183.86, with 95 and 107 cases diagnosed in the respective algorithms.

CONCLUSION: The introduction of the Xpert-based algorithm resulted in substantial cost increases. This was not matched by the expected increase in TB diagnostic efficacy, calling into question the sustainability of this expensive new technology.

Item Type: Journal Article
Subjects: R Medicine > RB Pathology
R Medicine > RC Internal medicine
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
SWORD Depositor: Library Publications Router
Library of Congress Subject Headings (LCSH): Tuberculosis -- Treatment -- Cost effectiveness, Diagnosis, Laboratory
Journal or Publication Title: The International Journal of Tuberculosis and Lung Disease
Publisher: International Union against Tuberculosis and Lung Disease,Union Internationale contre la Tuberculose et les Maladies Respiratoires
ISSN: 1815-7920
Official Date: 1 October 2016
Dates:
DateEvent
1 October 2016Published
10 May 2016Accepted
Volume: 20
Number: 10
Number of Pages: 9
Page Range: pp. 1377-1385
DOI: 10.5588/ijtld.16.0081
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access
Date of first compliant deposit: 12 January 2017
Date of first compliant Open Access: 1 April 2017
Funder: United States. Agency for International Development (USAID)
Grant number: TREAT TB – Agreement No. GHN -A-00-08-00004-00

Request changes or add full text files to a record

Repository staff actions (login required)

View Item View Item

Downloads

Downloads per month over past year

View more statistics

twitter

Email us: wrap@warwick.ac.uk
Contact Details
About Us