ArticleEClinicalMedicine2025
Cost-effectiveness of targeted next-generation sequencing (tNGS) for detection of tuberculosis drug resistance in India, South Africa and Georgia: a modeling analysis.
Article in EClinicalMedicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Development of a recombinase-aided amplification assay for rapid and sensitive detection ofExperimental and therapeutic medicine · 2026Article
- Pilot evaluation of a compact targeted next-generation sequencing with minimum biocontainment for rapid diagnosis of drug-resistant tuberculosis.Microbiology spectrum · 2026Article
- Targeted next-generation sequencing implementation in Eswatini identifies rifampicin and bedaquiline resistance undetected by routine diagnostic testing.Nature communications · 2026Article
- Future-proofing tuberculosis therapy: framework for concurrent drug and resistance testing development.The Lancet. Infectious diseases · 2026Review
- The Impact of Adopting Whole-Genome Sequencing for Tuberculosis Diagnosis in China: A Cost-Effectiveness Analysis.Open forum infectious diseases · 2026Article
- Clinical evaluation of a commercial culture-free targeted next-generation sequencing test for diagnosis of drug-resistant tuberculosis.Microbiology spectrum · 2026Article
- Targeted Next-Generation Sequencing in Drug-Resistant Tuberculosis: WHO Guidance and Practical Implementation Priorities.Biomedicines · 2026Review
- Diagnosis and Therapeutic Challenges of Drug-Resistant Tuberculosis Infection After Kidney Transplantation: A Rare Case Report.Infection and drug resistance · 2026Article
- Rapid Molecular Diagnostics of Tuberculosis: What Do We Have, What Do We Need?Pulmonary medicine · 2026Review
- Expanding diagnostic testing for drug-resistant tuberculosis in high burden settings: a cost-effectiveness analysis.BMC public health · 2025Article
- Reimagining Tuberculosis Control in the Era of Genomics: The Case for Global Investment inPathogens (Basel, Switzerland) · 2025Review
- First detection of HBV nucleic acid in the lung tissue of a patient with spontaneous recovery from HBV infection by tNGS: a case report.BMC infectious diseases · 2025Article
- Article
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Authors and funding
5 authors.
Funding
Abstract
Background: Targeted next-generation sequencing (tNGS) is promising alternative to phenotypic drug susceptibility testing (pDST) for detecting drug-resistant tuberculosis (DRTB). This study explored the potential cost-effectiveness of tNGS for the diagnosis of DR-TB across 3 settings: India, South Africa and Georgia. Methods: To inform WHO guideline development group (GDG) on tNGS we developed a stochastic decision analysis model and assessed cost-effectiveness of tNGS for DST among rifampicin resistance individuals. We also assessed tNGS as initial test for TB drug resistance in bacteriologically confirmed TB. Diagnostic accuracy and cost data were sourced from a systematic review conducted for GDG, covering studies published until September 2022. The primary outcome was incremental cost (2021 US$) per disability-adjusted life year (DALY) averted. Findings: tNGS when compared with in-country DST, tNGS proved cost-effective in South Africa (ICER: $15,619/DALY averted, WTP: $21,165) but not in Georgia (ICER: $18,375/DALY averted, WTP: $15,069). In India, tNGS dominated in-country DST practice, providing greater health impact at lower cost. When comparing tNGS with universal pDST, tNGS was dominated by pDST in all three countries. In Georgia, using tNGS as initial test for TB drug-resistance compared to Xpert MTB/Rif followed by pDST appeared cost-effective. Scenario with 50% reduction in tNGS test kit costs made tNGS cost-effective across all three countries, while a high Bedaquiline resistance prevalence (30%) led to a worsening cost-effectiveness. Interpretation: tNGS may be cost-effective in India, South Africa and Georgia when comprehensive DST is not routinely performed. Thus, existing DST practice and healthcare infrastructure should be considered before implementation and scale-up of tNGS. Funding: Global Tuberculosis Program, World Health Organization (2022/1249364-0).
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