ArticleClinicoEconomics and outcomes research : CEOR2022
Cost-Utility Analysis of Molecular Testing for Tuberculosis Diagnosis in Suspected Pulmonary Tuberculosis in Thailand.
Article in ClinicoEconomics and outcomes research : CEOR, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 9 citations in OpenAlex.
- Health economic evaluations of diagnostic tests for tuberculosis: a narrative review.Health economics review · 2025Review
- Economic evaluation of diagnostic tests for Thai patients with tuberculosis: A dynamic transmission model approach.PloS one · 2025Article
- Early cost-effectiveness analysis of a novel rapid diagnostic test for tuberculosis in rural Philippine settings.PLOS global public health · 2025Article
- Economic Evaluation of Molecular Testing for Pulmonary Tuberculosis Diagnosis: A Systematic Review.ClinicoEconomics and outcomes research : CEOR · 2025Review
- Cost-effectiveness of diagnostic tools and strategies for the screening and diagnosis of tuberculosis disease and infection: a scoping review.BMJ public health · 2024Review
- Whole-Genome Sequencing to PredictAntibiotics (Basel, Switzerland) · 2023Article
- Fluorescence In Situ Hybridization (FISH) Tests for Identifying Protozoan and Bacterial Pathogens in Infectious Diseases.Diagnostics (Basel, Switzerland) · 2022Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeGiven the lack of economic evaluation study of molecular testing in Thailand, this study aimed to evaluate the cost-utility of molecular testing algorithms including Xpert MTB/RIF and the loop-mediated isothermal amplification (TB-LAMP) in the general population suspected of having pulmonary TB based on a societal perspective.
methodsA hybrid decision tree Markov model using a 1-month cycle length was used to evaluate costs and outcomes of five TB diagnostic algorithms: 1) sputum smear microscopy (SSM) with culture and drug susceptibility testing (DST), 2) Xpert MTB/RIF add-on, 3) Xpert MTB/RIF initial, 4) TB-LAMP add-on, and 5) TB-LAMP initial during a lifetime period. All costs were calculated in 2021 Baht, and results were presented as an incremental cost-effectiveness ratio (ICER) for molecular testing compared with SSM with culture. One-way sensitivity and probability analyses were used to evaluate uncertainty input parameters.
resultsTB-LAMP was less expensive overall (6565 Baht) than Xpert MTB/RIF (7010 Baht) and SSM with culture (6845 Baht). Molecular testing was projected to improve quality adjusted life year (QALY) by 0.53 to 0.94 years. In comparison to SSM with culture and DST, providing an initial TB-LAMP test was the most preferred choice. Xpert MTB/RIF Initial had the lowest ICER (197 Baht per QALY gained), followed by TB-LAMP Add-on (993 Baht per QALY gained) and Xpert MTB/RIF Add-on (3940 Baht per QALY gained). One-way sensitivity analysis uncovered that sensitivity of TB-LAMP was greater than that of other parameters.
conclusionProviding molecular testing including Xpert MTB/RIF and TB-LAMP as either initial or add-on test for TB diagnosis was more cost-effective than SSM with culture and DST in the general population with suspected pulmonary TB in Thailand. Our study could provide useful evidence to policymakers advocating for inclusion of molecular testing in the universal health coverage benefit package in Thailand.
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