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Economic evaluation of novel Mycobacterium tuberculosis specific antigen-based skin tests for detection of TB infection: A modelling study

Author

Listed:
  • Lara Goscé
  • Kasim Allel
  • Yohhei Hamada
  • Alexei Korobitsyn
  • Nazir Ismail
  • Saima Bashir
  • Claudia M Denkinger
  • Ibrahim Abubakar
  • Peter J White
  • Molebogeng X Rangaka

Abstract

Evidence on the economic impact of novel skin tests for tuberculosis infection (TBST) is scarce and limited by study quality. We used estimates on the cost-effectiveness of the use of TBST compared to current tuberculosis infection (TBI) tests to assess whether TBST are affordable and feasible to implement under different country contexts. A Markov model parametrised to Brazil, South Africa and the UK was developed to compare the cost-effectiveness of three TBI testing strategies: (1) Diaskintest (DST), (2) TST test, and (3) IGRA QFT test. Univariate and probabilistic sensitivity analyses over unit costs and main parameters were performed. Our modelling results show that Diaskintest saves $5.60 and gains 0.024 QALYs per patient and $8.40, and 0.01 QALYs per patient in Brazil, compared to TST and IGRA respectively. In South Africa, Diaskintest is also cost-saving at $4.39, with 0.015 QALYs per patient gained, compared to TST, and $64.41, and 0.007 QALYs per patient, compared to IGRA. In the UK, Diaskintest saves $73.33, and gaines 0.0351 QALYs per patient, compared to TST. However, Diaskintest, compared to IGRA, showed an incremental cost of $521.45 (95% CI (500.94–545.07)) per QALY, below the willingness-to-pay threshold of $20.223 per QALY. Diaskintest potentially saves costs and results in greater health gains than the TST and IGRA tests in Brazil and South Africa. In the UK Diaskintest would gain health but also be more costly. Our results have potential external validity because TBST remained cost-effective despite extensive sensitivity analyses.

Suggested Citation

  • Lara Goscé & Kasim Allel & Yohhei Hamada & Alexei Korobitsyn & Nazir Ismail & Saima Bashir & Claudia M Denkinger & Ibrahim Abubakar & Peter J White & Molebogeng X Rangaka, 2023. "Economic evaluation of novel Mycobacterium tuberculosis specific antigen-based skin tests for detection of TB infection: A modelling study," PLOS Global Public Health, Public Library of Science, vol. 3(12), pages 1-13, December.
  • Handle: RePEc:plo:pgph00:0002573
    DOI: 10.1371/journal.pgph.0002573
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    1. Rafaela Borge Loureiro & Ethel Leonor Noia Maciel & Rosangela Caetano & Renata Lyrio Peres & Geisa Fregona & Jonathan E Golub & José Ueleres Braga, 2019. "Cost-effectiveness of QuantiFERON-TB Gold In-Tube versus tuberculin skin test for diagnosis and treatment of Latent Tuberculosis Infection in primary health care workers in Brazil," PLOS ONE, Public Library of Science, vol. 14(11), pages 1-24, November.
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