Abbott realtime MTB assay for detecting Mycobacterium tuberculosis complex in respiratory specimens: a cost-benefit analysis

• Published in: European journal of clinical microbiology & infectious diseases Vol. 43; no. 9; pp. 1699 - 1709
• Main Authors: Ferrer, Josep, Giménez, Estela, Carretero, Diego, Clari, Mª Ángeles, Orta, Nieves, Navarro, David, Albert, Eliseo
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2024; Springer Nature B.V
• Subjects: Adult; Aged; Biomedical and Life Sciences; Biomedicine; Cost benefit analysis; Economic analysis; Female; Humans; Internal Medicine; Male; Markov Chains; Medical Microbiology; Middle Aged; Molecular Diagnostic Techniques - economics; Molecular Diagnostic Techniques - methods; Mycobacterium tuberculosis; Mycobacterium tuberculosis - genetics; Mycobacterium tuberculosis - isolation & purification; Original Article; Patients; Polymerase chain reaction; Tuberculosis; Tuberculosis - diagnosis; Tuberculosis - economics; Tuberculosis - microbiology; Tuberculosis, Pulmonary - diagnosis; Tuberculosis, Pulmonary - economics; Tuberculosis, Pulmonary - microbiology; Young Adult; Molecular screening; Cost-benefit; Markov model; Economic evaluation; Mycobacterium tuberculosis
• ISSN: 0934-9723; 1435-4373; 1435-4373
• DOI: 10.1007/s10096-024-04880-1

Purpose Molecular screening for Mycobacterium tuberculosis (MTB) can lead to rapid empirical treatment inception and reduce hospitalization time and complementary diagnostic tests. However, in low-prevalence settings, the cost-benefit balance remains controversial due to the high cost. Methods We used a Markov model to perform an economic analysis to evaluate the profit after implementing molecular MTB screening (Period B) compared with conventional culture testing (Period A) in respiratory samples from 7,452 consecutive subjects with presumed tuberculosis (TB). Results The proportion of positivity was comparable between both periods ( P  > 0.05), with a total of 2.16 and 1.78 samples/patient requested in periods A and B, respectively ( P  < 0.001). The mean length of hospital stay was 8.66 days (95%CI: 7.63–9.70) in Period B and 11.51 days (95%CI: 10.15–12.87) in Period A ( P  = 0.001). The healthcare costs associated with diagnosing patients with presumed TB were reduced by €717.95 per patient with PCR screening. The probability of remaining hospitalized and the need for a greater number of outpatient specialty care visits were the variables with the most weight in the model. Conclusion Employing PCR as an MTB screening method in a low-prevalence setting may increase the profits to the system.