A systematic review on cost-effectiveness of diagnostic methods and treatments for tuberculosis in India

Abstract

Objective

Cost-effectiveness of a treatment is based on additional health benefits offered and for a test it is determined by fast and improved diagnosing capacity. Evidence on cost-effectiveness can help in identifying interventions that give optimal value for money and catalyse the effort of eliminating tuberculosis burden. Our objective is to evaluate and identify the cost-effectiveness of diagnostics and treatments for tuberculosis practiced in India from costing studies.

Methods

Electronic databases like PubMed, Web of Science, Scopus, ProQuest, Cochrane Library, and PlosOne are searched, from Jan 1995 to Jan 2023 based on the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. Quality of the selected studies is assessed using a consensus health economic criteria checklist.

Results

Among the twelve studies selected after quality assessment seven studies were on testing methods and five were on treatment interventions. The included, model-based studies used either state transition or decision tree model for cost analysis primarily in a health system perspective. Sputum smear microscopy test being dominated by other testing methods, strategies like public-private with right diagnostic method yields cost-effective results in tuberculosis healthcare.

Conclusion

Full economic evaluations on interventions for tuberculosis in India are scarce, particularly from patients’ perspective. The study provides holistic knowledge about the economic evaluations of tuberculosis tests and treatments, highlighting its applications and implemental complications for further development of improved strategies and economic evaluation.