Cost-effectiveness analysis of methods of diagnosis of tb infection in russian regions by use of recombinant tb allergen in children and adolescents

• Published in: Journal of health policy & outcomes research no. 2; pp. 40 - 45
• Main Authors: Hołownia-Voloskova, Malwina, Bashlakova, Ekaterina, Ermolaeva, Tatyana, Davydovskaya, Maria, Evdoshenko, Evgeniy
• Format: Journal Article
• Language: English
• Published: 14.12.2017
• ISSN: 2299-1247; 2299-1247
• DOI: 10.7365/JHPOR.2017.2.5

Background. Russia is among the countries with a high burden of TB. A new diagnostic method for TB has been developed, called ‘recombinant tuberculosis allergen’ or RTA (Diaskintest®), which has a similar cost and method of administration to the Mantoux test, but the principle of action, sensitivity and specificity are similar to IGRA technology. Despite the improvements of RTA, TB experts continue to use the Mantoux test. The aim of this study was to determine the most cost-effective medical technology for diagnosing tuberculosis infection in the Russian Federation, basing on calculation of ICER. Methods. The study was based on 3 models simulating the diagnosis of TB in Russia: 1-Mantoux test and further diagnostics methods (based on screening in 2008 in 1,302,490 Moscow children and adolescents); 2-Mantoux test with subsequent use of RTA in case of a positive Mantoux test, combined with further diagnostics methods (based on screening in 2013 in 1,420,100 Moscow children and adolescents); 3-RTA alone and further diagnostics methods (data based on screening conducted in 2015 in 108,729 Penza region children and adolescents 8-17 y.o.). Results. Method effectiveness (percentage of active TB infection among screened individuals), was 0.006%, 0.012% and 0.019% for models 1, 2 and 3, respectively. Cost-effectiveness ratios were 41861.67, 18401.67 and 10512.12 for models 1, 2 and 3, respectively. Conclusions. RTA is the most cost-effective tuberculosis screening method in children and adolescents, superior to both the stand-alone Mantoux test or the Mantoux test followed by RTA.