An assessment of nucleic acid amplification testing for active mycobacterial infection


Appendix H Economic literature search



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Appendix H Economic literature search

Literature search for previously published economic evaluations of NAAT


(tuberculosis OR MTB OR MTB/RIF OR “tubercle bacillus” OR Tuberculosis [MeSH] OR “M. bovis” OR “M. africanum” OR “M. microti” OR “M. canetti”) AND (Amplicor OR Amplified OR “Direct Test” OR “Direct Detection” OR TaqMan OR Xpert OR “nucleic acid amplification” OR NAAT OR “Nucleic Acid Amplification Techniques” [MeSH]) AND (economic evaluation OR cost effectiveness OR cost utility OR decision model)

Database

Last updated

Centre for Reviews and Dissemination database – including Database of Abstracts of Reviews of Effects, the Health Technology Assessment Database, the NHS Economic Evaluation Database

19 May 2014

PubMed

19 May 2014


Literature search for utility weights in TB


Tuberculosis AND (quality of life OR utility OR EQ-5D OR euroqol OR time trade off OR standard gamble OR visual analogue scale OR VAS OR SF-36 OR SF-6D OR SF 6D OR SF 36 OR EQ 5D)

Database

Last updated

PubMed

15 August 2014


Appendix I Additional information relating to the economic evaluation

Amikacin administration costs


Table 102 Amikacin administration costs

-

False-positive MDR-TB

True MDR-TB

Average administrations per week

5

4

Weeks treated

8.7

26.1

Total amikacin administrations

43.5

104.4

In-patient administrations

9.3

14.9

Outpatient administrations

34.2

89.5

Cost of outpatient administration

$234

$234

Total administration costs

$8,002

$20,943

MDR-TB = multidrug-resistant tuberculosis

Utility values


Table 103 Utility values identified in studies that elicit utilities in a TB population

Study

Utility weight

Comments

Winetsky et al. (2012)

No TB / recovered 1.00

Active TB ± MDR, undiagnosed 0.73

Active TB ± MDR, AFB treated 0.68

Active TB ± MDR, AFB+ treated 0.60



Former Soviet Union prison inmates—unclear how preferences were elicited

Kittikraisak et al. (2012)

TB (treated) 0.65

MDR-TB (treated) 0.49

Cured TB ± MDR 0.89

HIV (no TB) 0.75

HIV with TB (treated) 0.62

Cured TB ± MDR with HIV 0.88



Thai patients diagnosed with TB (including those on treatment and those who had completed treatment) and/or HIV

EQ-5D weights adjusted for age and monthly household income (also presents unadjusted weights with standard error)



Awaisu et al. (2012)

At baseline 0.70

At 3 months treatment 0.87

At 6 months treatment 0.91


Malaysian smokers newly diagnosed with TB

EQ-5D weights for control group (treatment administered by DOTS)



Kruijshaar et al. (2010) (reported in Jit et al. (2011))

Untreated TB 0.68

After 2 months treatment 0.81



UK patients diagnosed with active TB were administered generic health-related quality-of-life questionnaires (EQ-5D and SF-36) at diagnosis and 2 months into therapy. The median time between questionnaires was 73 days (IQR: 54-104)

Overall scores are not reported in Krujisharr et al. (2010), but are reported in Jit et al. (2011)



Babikako et al. (2010)

At baseline 0.607

At 2 months treatment 0.671

At 8 months treatment 0.785


Ugandan patients with known HIV status and TB enrolled based on duration of TB therapy: started at 2 months and completed at 8 months

Guo et al. (2008)

Active TB (treated) 0.68 (0.65–0.72)

By severity of TB symptoms:

Very mild 0.84 (0.11)

Mild 0.68 (0.05)

Moderate 0.64 (0.10)

Severe 0.59 (0.15)

Very severe 0.54 (0.08)


Canadian patients with recent diagnosis of active TB (within 2 months)

Measure using the SF-6D (also HUI2, HUI3 and VAS)



Also reports by self-reported symptom control

AFB = acid-fast bacilli; DOTS = directly observed treatment, short-course; HIV = human immunodeficiency virus; IQR = inter-quartile range; MDR = multidrug-resistant; MDR-TB = multidrug-resistant tuberculosis; TB = tuberculosis; VAS = visual analogue scale

Results of the economic evaluation


Results of the economic evaluation, AFB model arm

Figure 55 Results of the economic evaluation, AFB model arm



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