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Table 2 Incremental cost-effectiveness of decentralized versus centralized Xpert testing

From: Informing decision-making for universal access to quality tuberculosis diagnosis in India: an economic-epidemiological model

 

Centralized Xpert with 95% cost sharing for specimen transport

Centralized Xpert with no cost sharing for specimen transport

Decentralized Xpert with test volume at 3 per day

Decentralized Xpert with test volume at 0.3 per day

Total costs (2015 US$, in million)

$189 [$157–$222]

$196 [$164–$230]

$196 [$164–$230]

$217 [$185–$253]

Total DALYs

740,124 [700,676–782,488]

730,923 [692,001–773,630]

Comparing centralized vs. decentralized Xpert

Centralized Xpert

vs.

Decentralized Xpert

Difference in costs (2015 US$, in million)

Difference in DALYs

Cost per DALY averted (2015 US$)

95% cost sharing for specimen transport

vs.

Test volume at 3 per day

$7 [$6.6–$8]

9.26 [6231–12,112]

$795 [$573–$1213]

No cost sharing for specimen transport

vs.

Test volume at 3 per day

− $0.33 [− $0.89 to $0.22]

Dominated* [dominated*–$29]

95% cost sharing for specimen transport

vs.

Test volume at 0.3 per day

$28 [$27–$30]

$3161 [$2412–$4731]

No cost sharing for specimen transport

vs.

Test volume at 0.3 per day

$21 [$20–$22]

$2339 [$1775–$3501]

  1. A total of four cost sets were compared in the cost-effectiveness analysis. All values are expressed as median with interquartile ranges in brackets, cumulative and discounted over a 10-year time horizon
  2. *In the median simulations, decentralized Xpert was less costly and more effective than centralized testing