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Abstract
Tuberculosis continues to be a major global health problem. Lack of accurate, rapid and cost-effective diagnostic tests poses a huge obstacle to global TB control. While several new diagnostic tools are being developed and evaluated for TB, it is important that new tools are introduced for widespread use only after careful validation of accuracy, impact as well as cost–effectiveness in real-world settings. While there are large numbers of studies on the accuracy of TB diagnostic tests, there are few studies that are focused on cost and cost–effectiveness. There are currently no widely accepted standards on how to evaluate costs of a TB test. In this review, we describe the basic approach for computing the costs of TB diagnostic tests, and provide templates for various data elements and parameters that go into the costing analysis. We hope this will pave the way for a standardized methodology for costing of TB diagnostic tests. Such a tool would enable improved and more generalizable costing analyses that can provide a strong foundation for more sophisticated economic analyses that evaluate the full economic and epidemiological impact resulting from the implementation and routine use of performance-verified new and innovative diagnostic tools. This, in turn, will facilitate evidence-based adoption and use of new diagnostics, especially in resource-limited settings.
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Acknowledgements
The authors are grateful to Heather Alexander Konopka for useful input and suggestions.
Financial & competing interests disclosure
Hojoon Sohn, Heidi Albert and Madhukar Pai are affiliated with the Foundation for Innovative New Diagnostics (FIND), Geneva. FIND is a nonprofit agency that works with several industry partners in developing and evaluating new diagnostics for neglected infectious diseases. This work was supported in part by Canadian Institutes for Health Research (CIHR) grant MOP-89918, and European Commission grant TBSusgent (FP7-HEALTH-2007-B). Madhukar Pai is supported by a CIHR New Investigator Award. Keertan Dheda is supported by a SARChI award and MRC Career Development Award. These funding agencies had no role in the development of this manuscript. The authors have no other financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
No writing assistance was utilized in the production of this manuscript.