Cost-effectiveness comparison of Genechip and conventional drug susceptibility test for detecting multidrug-resistant tuberculosis in China

Abstract

Background: Genechip (CapitalBio, Beijing, China) is a system for diagnosing resistance to rifampin and isoniazid, which shows high efficiency in detecting drug-resistant tuberculosis. Here, we firstly evaluated the costs of Genechip for detecting the drug susceptibility of Mycobacterium tuberculosis, compared to conventional drug susceptibility test (DST) in laboratories in China.

Methodology/principal findings: Data on the costs of the two tests were collected at four hospitals. Costs were calculated using the essential factor cost calculation method. The costs of diagnosing a single case of multidrug-resistant tuberculosis (MDR-TB) using Genechip and DST were US$22.38 and $53.03, respectively. Taking into account the effect on costs from failure of a certain number of tests to accurately diagnose MDR-TB, the costs of Genechip and DST increased by 17.65% and 5.22%, respectively. The cost of both tests decreased with the increasing prevalence of MDR-TB disease, and the cost of Genechip at a sensitivity of more than 50% was lower than that of DST. When price of Genechip was varied to 50%, 80%, 150%, and 200% of the original price, the cost of Genechip at sensitivities of more than 30%, 40%, 60%, and 70%, respectively, was also lower than that of DST.

Conclusions/significance: This study showed that Genechip was a more cost-effective method of diagnosing MDR-TB compared to conventional DST.

Figure 1. Effect of sensitivity and MDR-TB prevalence on cost of diagnosis using Genechip and conventional DST.

Figure 2. Effect of the price of Genechip on the cost of diagnosis.

A–D represents the costs of diagnosing a single case of MDR-TB by Genechip with various sensitivities at various prevalence rates when the price of Genechip is adjusted to 50%, 80%, 150%, and 200% of the current price level.