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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 transportCentralized Xpert with no cost sharing for specimen transportDecentralized Xpert with test volume at 3 per dayDecentralized 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–$253]
Total DALYs740,124 [700,676–782,488]730,923 [692,001–773,630]
Comparing centralized vs. decentralized Xpert
Centralized Xpertvs.Decentralized XpertDifference in costs (2015 US$, in million)Difference in DALYsCost per DALY averted (2015 US$)
95% cost sharing for specimen transportvs.Test volume at 3 per day$7 [$6.6–$8]9.26 [6231–12,112]$795 [$573–$1213]
No cost sharing for specimen transportvs.Test volume at 3 per day− $0.33 [− $0.89 to $0.22]Dominated* [dominated*–$29]
95% cost sharing for specimen transportvs.Test volume at 0.3 per day$28 [$27–$30]$3161 [$2412–$4731]
No cost sharing for specimen transportvs.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