Sohn Hojoon, Minion Jessica, Albert Heidi, Dheda Keertan, Pai Madhukar
Doctoral Scholar, Department of Epidemiology, Biostatistics and Occupational Health McGill University, 1020 Pine Avenue West, Montreal, QC H3A 1A2, Canada and Consultant, Foundation for Innovative New Diagnostics, Geneva, Switzerland.
Expert Rev Anti Infect Ther. 2009 Aug;7(6):723-33. doi: 10.1586/eri.09.52.
Tuberculosis continues to be a major global health problem. Lack of accurate, rapid and cost-effective diagnostic tests poses a huge obstacle to global TB control. While several new diagnostic tools are being developed and evaluated for TB, it is important that new tools are introduced for widespread use only after careful validation of accuracy, impact as well as cost-effectiveness in real-world settings. While there are large numbers of studies on the accuracy of TB diagnostic tests, there are few studies that are focused on cost and cost-effectiveness. There are currently no widely accepted standards on how to evaluate costs of a TB test. In this review, we describe the basic approach for computing the costs of TB diagnostic tests, and provide templates for various data elements and parameters that go into the costing analysis. We hope this will pave the way for a standardized methodology for costing of TB diagnostic tests. Such a tool would enable improved and more generalizable costing analyses that can provide a strong foundation for more sophisticated economic analyses that evaluate the full economic and epidemiological impact resulting from the implementation and routine use of performance-verified new and innovative diagnostic tools. This, in turn, will facilitate evidence-based adoption and use of new diagnostics, especially in resource-limited settings.
结核病仍然是一个重大的全球健康问题。缺乏准确、快速且具有成本效益的诊断测试给全球结核病控制带来了巨大障碍。虽然正在研发和评估多种用于结核病的新诊断工具，但重要的是，新工具只有在经过在实际环境中对准确性、影响以及成本效益的仔细验证之后，才应被广泛使用。虽然有大量关于结核病诊断测试准确性的研究，但很少有研究关注成本和成本效益。目前对于如何评估结核病检测的成本尚无广泛认可的标准。在本综述中，我们描述了计算结核病诊断测试成本的基本方法，并为成本分析中涉及的各种数据元素和参数提供了模板。我们希望这将为结核病诊断测试成本核算的标准化方法铺平道路。这样一种工具将能够进行改进且更具普遍性的成本分析，为更复杂的经济分析提供坚实基础，这些经济分析用于评估经性能验证的新型创新诊断工具的实施和常规使用所产生的全面经济和流行病学影响。反过来，这将促进基于证据采用和使用新的诊断方法，特别是在资源有限的环境中。
