by Anna Vassall, Mariana Siapka, Nicola Foster et al.
The Lancet Global Health, Vol. 5, No. 7, e710–e719, July 2017
In 2010 a new diagnostic test for tuberculosis, Xpert MTB/RIF, received a conditional programmatic recommendation from WHO. Several model-based economic evaluations predicted that Xpert would be cost-effective across sub-Saharan Africa. The authors investigated the cost-effectiveness of Xpert in the real world during national roll-out in South Africa. They we found that Xpert introduction in South Africa was cost-neutral, but found no evidence that Xpert improved the cost-effectiveness of tuberculosis diagnosis. Their study highlights the importance of considering implementation constraints, when predicting and evaluating the cost-effectiveness of new tuberculosis diagnostics in South Africa.