Cost-effectiveness study of the microbiological diagnosis of tuberculosis using geneXpert MTB/RIF (R)
Por:
Herráez Ó, Asencio-Egea MÁ, Huertas-Vaquero M, Carranza-González R, Castellanos-Monedero J, Franco-Huerta M, Barberá-Farré JR and Tenías-Burillo JM
Publicada:
1 ago 2017
Ahead of Print:
18 jul 2016
Categoría:
Microbiology (medical)
Resumen:
Introduction/Objective: To perform a cost-effectiveness analysis of a
molecular biology technique for the diagnosis of tuberculosis compared
to the classical diagnostic alternative.
Methods: A cost-effectiveness analysis was performed to evaluate the
theoretical implementation of a molecular biology method including two
alternative techniques for early detection of Mycobacterium tuberculosis
Complex, and resistance to rifampicin (alternative 1: one determination
in selected patients; alternative 2: two determinations in all the
patients). Both alternatives were compared with the usual procedure for
microbiological diagnosis of tuberculosis (staining and microbiological
culture), and was accomplished on 1,972 patients in the period in
2008-2012. The effectiveness was measured in QALYs, and the uncertainty
was assessed by univariate, multivariate and probabilistic analysis of
sensitivity.
Results: A value of (sic)8,588/QALYs was obtained by the usual method.
Total expenditure with the alternative 1 was (sic)8,487/QALYs, whereas
with alternative 2, the cost-effectiveness ratio amounted to
(sic)2,960/QALYs. Greater diagnostic efficiency was observed by applying
the alternative 2, reaching a 75% reduction in the number of days that a
patient with tuberculosis remains without an adequate treatment, and a
70% reduction in the number of days that a patient without tuberculosis
remains in hospital.
Conclusion: The implementation of a molecular microbiological technique
in the diagnosis of tuberculosis is extremely cost-effective compared to
the usual method. Its introduction into the routine diagnostic procedure
could lead to an improvement in quality care for patients, given that it
would avoid both unnecessary hospitalisations and treatments, and
reflected in economic savings to the hospital. (C) 2016 Elsevier Espana,
S.L.U. and Sociedad Espanola de Enfermedades Infecciosas y Microbiologia
Clinica. All rights reserved.
Filiaciones:
Herráez Ó:
Laboratorio de Análisis Clínicos, Hospital General La Mancha Centro, Alcázar de San Juan, Ciudad Real, España
Asencio-Egea MÁ:
Laboratorio de Microbiología, Hospital General La Mancha Centro, Alcázar de San Juan, Ciudad Real, España.
Huertas-Vaquero M:
Laboratorio de Microbiología, Hospital General La Mancha Centro, Alcázar de San Juan, Ciudad Real, España
Carranza-González R:
Laboratorio de Microbiología, Hospital General La Mancha Centro, Alcázar de San Juan, Ciudad Real, España
Castellanos-Monedero J:
Servicio de Medicina Interna, Hospital General La Mancha Centro, Alcázar de San Juan, Ciudad Real, España
Franco-Huerta M:
Servicio de Medicina Interna, Hospital General La Mancha Centro, Alcázar de San Juan, Ciudad Real, España
Barberá-Farré JR:
Servicio de Medicina Interna, Hospital General La Mancha Centro, Alcázar de San Juan, Ciudad Real, España
:
Unidad de Apoyo a la Investigación, Hospital General La Mancha Centro, Alcázar de San Juan, Ciudad Real, España
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