Genotype®MTBDRplus and xpert®MTB/RIF in the diagnosis of tuberculosis and resistant tuberculosis: Cost analysis in a tertiary referral hospital

Abstract

Introduction: The present study sought to assess the mean and activity based cost (ABC) of the laboratory diagnosis for tuberculosis through the application of conventional and molecular techniques—Xpert®MTB/RIF and Genotype®MTBDRplus—in a tertiary referral hospital in Brazil. Methods: The mean cost and ABC formed the basis for the cost analysis of the TB laboratory diagnosis. Results: The mean cost and ABC were US$ 4.00 and US$ 3.24, respectively, for a bacilloscopy; US$ 6.73 and US$ 5.27 for a Lowenstein-Jensen (LJ) culture; US$ 105.42 and US$ 76.56 for a drug sensitivity test (DST)–proportions method (PM) in LJ; US$ 148.45 and US$ 136.80 for a DST–BACTEC™ MGIT™ 960 system; US$ 11.53 and US$ 9.89 for an Xpert®MTB/RIF; and US$ 84.21 and US$ 48.38 for a Genotype®MTBDRplus. Conclusions: The mean cost and ABC proved to be good decision-making parameters in the diagnosis of TB and MDR-TB. The effective implementation of algorithms will depend on the conditions at each location.