The cost effectiveness of genetic markers for antibiotic resistance in tuberculosis
Multi-drug resistant (MDR) and extensive-drug resistance (XDR) tuberculosis (TB) are relatively rare in the UK. However, their impact on the individual, their close contacts, and the health care economy is disproportionably large. Tests which can rapidly detect genetic markers of drug resistance have the potential to reduce this impact.
This study will investigate the clinical impact and cost-effectiveness of a range of rapid molecular biology-based tests detecting genetic markers of antibiotic resistance, compared with conventional culture and drug susceptibility testing. It will include a systematic review of evidence on the diagnostic accuracy of these tests.
In order to determine the clinical impact of earlier diagnosis, a transmission dynamic model will be developed to predict the number of infections averted with the genetic marker tests. This information will then be used to estimate the value for money potentially derived from earlier diagnosis and also to investigate the economics of alternative models of service delivery (centralised versus distributed testing).