ANALYSIS OF THE AVERAGE COSTS AND BY ACTIVITY OF THE SCOT-TB TEST FOR THE DIAGNOSIS OF PULMONARY TUBERCULOSIS IN PUBLIC LABORATORIES
Name: ISABELLA RECLA SEGATTO
Publication date: 25/08/2023
Examining board:
Name |
Role |
|---|---|
| MOISES PALACI | Advisor |
Summary: The laboratory diagnosis for the investigation of tuberculosis (TB) through culture and the identification of the Mycobacterium tuberculosis resistance profile by theantimicrobial susceptibility test (AST) is essential for disease control. However, the high costs and complexity of conventional methods for conducting these tests have reduced their availability through the Brazilian public healthcare system (SUS). In this context, facilitating access to diagnosis requires the adoption of new tests with easy operational methodologies and affordable costs. Prior to the adoption of new technologies for TB diagnosis, it is necessary for public health managers to perform economic evaluations comparing the costs of conventional Technologies to innovations. This study aimed to evaluate the average cost and activity-based cost (ABC) of the Swab Culture Optimized Test (SCOT-TB) test for the diagnosis of pulmonary tuberculosis in public laboratories with different levels of infrastructure and biosafety complexity. The cost analysis was based on two methods: average cost and ABC. The SCOT-TB phenotypic test, developed by researchers from Nucleus of Infectious Diseases of the Federal University of Espírito Santo (NDI-UFES), detects growth, identifies, and determines the sensitivity of the TB bacillus to isoniazid and rifampicin from sputum samples. The costs of SCOT-TB were compared to those of the BD BACTEC MGIT 960® test (MGIT), the gold standard method for culture and AST, conducted at the Laboratory of Mycobacteria Research at the Faculty of Medicine of the Federal University of Minas Gerais (LPM/FM/UFMG), classified as biosafety level 3 (BSL 3), and at the Laboratory of NDI-UFES, classified as biosafety level 2 (BSL2). At LPM/FM/UFMG, the results for average cost and ABC were respectively U$15.84/U$11.81 for SCOT-TB and U$20.59/U$14.25 for MGIT-culture. At NDI/UFES, the results for average cost and ABC were respectively U$16.84/U$10.99 for SCOT-TB, U$26.74/U$15.82 for MGIT-culture, and U$50.15/U$33.16 for MGIT-AST. Additionally, our results demonstrated that for all tests, the cost component with the highest contribution to both ABC and average cost was the input. Infrastructure, on the other hand, had the least impact on costs for all tests, noting that for the ABC of SCOT-TB, it was not relevant for either the BSL3 or BSL2 laboratory. Based on these findings, our study demonstrate that the SCOT-TB test reduces both the average cost and ABC of the diagnosis of pulmonary tuberculosis when compared to the standard method, BD BACTEC MGIT 960®, in all evaluated laboratories, regardless of the biosafety level.
