Costo-efectividad de tres pruebas diagnósticas de tuberculosis pulmonar en dos ciudades de Colombia, 2015

introduction. In Colombia there are different tests for tuberculosis diagnostic, smear microscopy is the most commonly used. With the availability of molecular tests, it is important to identify which are the most cost-effective options for tuberculosis diagnosis. objective. To evaluate the costs and cost-effectiveness of three pulmonary tuberculosis diagnostic tests, in two Colombia cities in 2015. methods. Descriptive and retrospective study. Results and commercial value of three diagnostic tests, used in pulmonary tuberculosis diagnosis in symptomatic patients from Medellin and Pereira cities during 2015 were collected. A cost-effectiveness analysis was conducted. results. In 1 424 cases of pulmonary tuberculosis in Medellin, each positive case detected by sputum smear had a cost of 930 519 Colombian pesos (cp) (300.17 dollars); by culture 1 640 770 cp (529.28 dollars) and 4 900 616 cp (1 580.84 dollars) by Xpert mtb/rif® (Xpert). Comparing with sputum smear there was an additional cost of 4 302 344 cp (1 387.85 dollars) and 26 207 467 cp (8 454.02 dollars) in every case detected by culture and Xpert, respectively. In 392 pulmonary tuberculosis cases in Pereira, each positive case had a cost of 471 615 cp (152.12 dollars), 997 315 cp (321.71 dollars) and 6 099 404 cp (1 967.55 dollars) by sputum smear, culture and Xpert, respectively. Culture and Xpert had a higher cost per every case of 2 968 690 cp (957.64 dollars) and 36 248 274 cp (11 692.99 dollars), respectively when comparing with smear microscopy. conclusion. Culture and the Xpert mtb are more expensive but more effective compared with smear microscopy. Culture is less expensive but less effective than Xpert mtb. According to the results, in Colombia the Xpert until now is not recommended as a routine diagnostic method; however, it should be taken into account for some specific cases considering a better diagnosis opportunity.