@article{Reddy2021,
abstract = {BACKGROUND: A novel urine lipoarabinomannan assay (FujiLAM) has higher sensitivity and higher cost than the first-generation AlereLAM assay. We evaluated the cost-effectiveness of FujiLAM for tuberculosis testing among hospitalized people with human immunodeficiency virus (HIV), irrespective of symptoms. METHODS: We used a microsimulation model to project clinical and economic outcomes of 3 testing strategies: (1) sputum Xpert MTB/RIF (Xpert), (2) sputum Xpert plus urine AlereLAM (Xpert+AlereLAM), (3) sputum Xpert plus urine FujiLAM (Xpert+FujiLAM). The modeled cohort matched that of a 2-country clinical trial. We applied diagnostic yields from a retrospective study (yields for Xpert/Xpert+AlereLAM/Xpert+FujiLAM among those with CD4 {\textless}200 cells/µL: 33{\%}/62{\%}/70{\%}; among those with CD4 ≥200 cells/µL: 33{\%}/35{\%}/47{\%}). Costs of Xpert/AlereLAM/FujiLAM were US{\$}15/3/6 (South Africa) and {\$}25/3/6 (Malawi). Xpert+FujiLAM was considered cost-effective if its incremental cost-effectiveness ratio (US{\$}/year-of-life saved) was {\textless}{\$}940 (South Africa) and {\textless}{\$}750 (Malawi). We varied key parameters in sensitivity analysis and performed a budget impact analysis of implementing FujiLAM countrywide. RESULTS: Compared with Xpert+AlereLAM, Xpert+FujiLAM increased life expectancy by 0.2 years for those tested in South Africa and Malawi. Xpert+FujiLAM was cost-effective in both countries. Xpert+FujiLAM for all patients remained cost-effective compared with sequential testing and CD4-stratified testing strategies. FujiLAM use added 3.5{\%} (South Africa) and 4.7{\%} (Malawi) to 5-year healthcare costs of tested patients, primarily reflecting ongoing HIV treatment costs among survivors. CONCLUSIONS: FujiLAM with Xpert for tuberculosis testing in hospitalized people with HIV is likely to increase life expectancy and be cost-effective at the currently anticipated price in South Africa and Malawi. Additional studies should evaluate FujiLAM in clinical practice settings.},
author = {Reddy, Krishna P and Denkinger, Claudia M and Broger, Tobias and Mccann, Nicole C and Gupta-Wright, Ankur and Kerkhoff, Andrew D and Pei, Pamela P and Shebl, Fatma M and Fielding, Katherine L and Nicol, Mark P and Horsburgh, C Robert and Meintjes, Graeme A and Freedberg, Kenneth A and Wood, Robin and Walensky, Rochelle P},
doi = {10.1093/CID/CIAA1698},
file = {:C$\backslash$:/Users/01462563/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Reddy et al. - 2021 - Cost-effectiveness of a novel lipoarabinomannan test for tuberculosis in patients with Human Immunodeficiency Viru.pdf:pdf},
issn = {1058-4838},
journal = {Clinical Infectious Diseases},
keywords = {OA,budgets,cost effectiveness,diagnosis,fund{\_}ack,hiv,life expectancy,lipoarabinomannan,malawi,original,sensitivity analysis,south africa,sputum,tuberculosis,urine},
mendeley-tags = {OA,fund{\_}ack,original},
month = {oct},
number = {7},
pages = {e2077--e2085},
pmid = {33200169},
publisher = {Oxford Academic},
title = {{Cost-effectiveness of a novel lipoarabinomannan test for tuberculosis in patients with Human Immunodeficiency Virus}},
url = {https://academic.oup.com/cid/article/73/7/e2077/5983890},
volume = {73},
year = {2021}
}

{"_id":"qN2JrwgxZSi3WkbDh","bibbaseid":"reddy-denkinger-broger-mccann-guptawright-kerkhoff-pei-shebl-etal-costeffectivenessofanovellipoarabinomannantestfortuberculosisinpatientswithhumanimmunodeficiencyvirus-2021","author_short":["Reddy, K. P","Denkinger, C. M","Broger, T.","Mccann, N. C","Gupta-Wright, A.","Kerkhoff, A. D","Pei, P. P","Shebl, F. M","Fielding, K. L","Nicol, M. P","Horsburgh, C R.","Meintjes, G. A","Freedberg, K. A","Wood, R.","Walensky, R. P"],"bibdata":{"bibtype":"article","type":"article","abstract":"BACKGROUND: A novel urine lipoarabinomannan assay (FujiLAM) has higher sensitivity and higher cost than the first-generation AlereLAM assay. We evaluated the cost-effectiveness of FujiLAM for tuberculosis testing among hospitalized people with human immunodeficiency virus (HIV), irrespective of symptoms. METHODS: We used a microsimulation model to project clinical and economic outcomes of 3 testing strategies: (1) sputum Xpert MTB/RIF (Xpert), (2) sputum Xpert plus urine AlereLAM (Xpert+AlereLAM), (3) sputum Xpert plus urine FujiLAM (Xpert+FujiLAM). The modeled cohort matched that of a 2-country clinical trial. We applied diagnostic yields from a retrospective study (yields for Xpert/Xpert+AlereLAM/Xpert+FujiLAM among those with CD4 \\textless200 cells/µL: 33%/62%/70%; among those with CD4 ≥200 cells/µL: 33%/35%/47%). Costs of Xpert/AlereLAM/FujiLAM were US$}15/3/6 (South Africa) and {$25/3/6 (Malawi). Xpert+FujiLAM was considered cost-effective if its incremental cost-effectiveness ratio (US$}/year-of-life saved) was {\\textless}{$940 (South Africa) and \\textless$}750 (Malawi). We varied key parameters in sensitivity analysis and performed a budget impact analysis of implementing FujiLAM countrywide. RESULTS: Compared with Xpert+AlereLAM, Xpert+FujiLAM increased life expectancy by 0.2 years for those tested in South Africa and Malawi. Xpert+FujiLAM was cost-effective in both countries. Xpert+FujiLAM for all patients remained cost-effective compared with sequential testing and CD4-stratified testing strategies. FujiLAM use added 3.5{%} (South Africa) and 4.7{%} (Malawi) to 5-year healthcare costs of tested patients, primarily reflecting ongoing HIV treatment costs among survivors. CONCLUSIONS: FujiLAM with Xpert for tuberculosis testing in hospitalized people with HIV is likely to increase life expectancy and be cost-effective at the currently anticipated price in South Africa and Malawi. Additional studies should evaluate FujiLAM in clinical practice settings.","author":[{"propositions":[],"lastnames":["Reddy"],"firstnames":["Krishna","P"],"suffixes":[]},{"propositions":[],"lastnames":["Denkinger"],"firstnames":["Claudia","M"],"suffixes":[]},{"propositions":[],"lastnames":["Broger"],"firstnames":["Tobias"],"suffixes":[]},{"propositions":[],"lastnames":["Mccann"],"firstnames":["Nicole","C"],"suffixes":[]},{"propositions":[],"lastnames":["Gupta-Wright"],"firstnames":["Ankur"],"suffixes":[]},{"propositions":[],"lastnames":["Kerkhoff"],"firstnames":["Andrew","D"],"suffixes":[]},{"propositions":[],"lastnames":["Pei"],"firstnames":["Pamela","P"],"suffixes":[]},{"propositions":[],"lastnames":["Shebl"],"firstnames":["Fatma","M"],"suffixes":[]},{"propositions":[],"lastnames":["Fielding"],"firstnames":["Katherine","L"],"suffixes":[]},{"propositions":[],"lastnames":["Nicol"],"firstnames":["Mark","P"],"suffixes":[]},{"propositions":[],"lastnames":["Horsburgh"],"firstnames":["C","Robert"],"suffixes":[]},{"propositions":[],"lastnames":["Meintjes"],"firstnames":["Graeme","A"],"suffixes":[]},{"propositions":[],"lastnames":["Freedberg"],"firstnames":["Kenneth","A"],"suffixes":[]},{"propositions":[],"lastnames":["Wood"],"firstnames":["Robin"],"suffixes":[]},{"propositions":[],"lastnames":["Walensky"],"firstnames":["Rochelle","P"],"suffixes":[]}],"doi":"10.1093/CID/CIAA1698","file":":C$\\$:/Users/01462563/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Reddy et al. - 2021 - Cost-effectiveness of a novel lipoarabinomannan test for tuberculosis in patients with Human Immunodeficiency Viru.pdf:pdf","issn":"1058-4838","journal":"Clinical Infectious Diseases","keywords":"OA,budgets,cost effectiveness,diagnosis,fund_ack,hiv,life expectancy,lipoarabinomannan,malawi,original,sensitivity analysis,south africa,sputum,tuberculosis,urine","mendeley-tags":"OA,fund_ack,original","month":"oct","number":"7","pages":"e2077–e2085","pmid":"33200169","publisher":"Oxford Academic","title":"Cost-effectiveness of a novel lipoarabinomannan test for tuberculosis in patients with Human Immunodeficiency Virus","url":"https://academic.oup.com/cid/article/73/7/e2077/5983890","volume":"73","year":"2021","bibtex":"@article{Reddy2021,\r\nabstract = {BACKGROUND: A novel urine lipoarabinomannan assay (FujiLAM) has higher sensitivity and higher cost than the first-generation AlereLAM assay. We evaluated the cost-effectiveness of FujiLAM for tuberculosis testing among hospitalized people with human immunodeficiency virus (HIV), irrespective of symptoms. METHODS: We used a microsimulation model to project clinical and economic outcomes of 3 testing strategies: (1) sputum Xpert MTB/RIF (Xpert), (2) sputum Xpert plus urine AlereLAM (Xpert+AlereLAM), (3) sputum Xpert plus urine FujiLAM (Xpert+FujiLAM). The modeled cohort matched that of a 2-country clinical trial. We applied diagnostic yields from a retrospective study (yields for Xpert/Xpert+AlereLAM/Xpert+FujiLAM among those with CD4 {\\textless}200 cells/µL: 33{\\%}/62{\\%}/70{\\%}; among those with CD4 ≥200 cells/µL: 33{\\%}/35{\\%}/47{\\%}). Costs of Xpert/AlereLAM/FujiLAM were US{\\$}15/3/6 (South Africa) and {\\$}25/3/6 (Malawi). Xpert+FujiLAM was considered cost-effective if its incremental cost-effectiveness ratio (US{\\$}/year-of-life saved) was {\\textless}{\\$}940 (South Africa) and {\\textless}{\\$}750 (Malawi). We varied key parameters in sensitivity analysis and performed a budget impact analysis of implementing FujiLAM countrywide. RESULTS: Compared with Xpert+AlereLAM, Xpert+FujiLAM increased life expectancy by 0.2 years for those tested in South Africa and Malawi. Xpert+FujiLAM was cost-effective in both countries. Xpert+FujiLAM for all patients remained cost-effective compared with sequential testing and CD4-stratified testing strategies. FujiLAM use added 3.5{\\%} (South Africa) and 4.7{\\%} (Malawi) to 5-year healthcare costs of tested patients, primarily reflecting ongoing HIV treatment costs among survivors. CONCLUSIONS: FujiLAM with Xpert for tuberculosis testing in hospitalized people with HIV is likely to increase life expectancy and be cost-effective at the currently anticipated price in South Africa and Malawi. Additional studies should evaluate FujiLAM in clinical practice settings.},\r\nauthor = {Reddy, Krishna P and Denkinger, Claudia M and Broger, Tobias and Mccann, Nicole C and Gupta-Wright, Ankur and Kerkhoff, Andrew D and Pei, Pamela P and Shebl, Fatma M and Fielding, Katherine L and Nicol, Mark P and Horsburgh, C Robert and Meintjes, Graeme A and Freedberg, Kenneth A and Wood, Robin and Walensky, Rochelle P},\r\ndoi = {10.1093/CID/CIAA1698},\r\nfile = {:C$\\backslash$:/Users/01462563/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Reddy et al. - 2021 - Cost-effectiveness of a novel lipoarabinomannan test for tuberculosis in patients with Human Immunodeficiency Viru.pdf:pdf},\r\nissn = {1058-4838},\r\njournal = {Clinical Infectious Diseases},\r\nkeywords = {OA,budgets,cost effectiveness,diagnosis,fund{\\_}ack,hiv,life expectancy,lipoarabinomannan,malawi,original,sensitivity analysis,south africa,sputum,tuberculosis,urine},\r\nmendeley-tags = {OA,fund{\\_}ack,original},\r\nmonth = {oct},\r\nnumber = {7},\r\npages = {e2077--e2085},\r\npmid = {33200169},\r\npublisher = {Oxford Academic},\r\ntitle = {{Cost-effectiveness of a novel lipoarabinomannan test for tuberculosis in patients with Human Immunodeficiency Virus}},\r\nurl = {https://academic.oup.com/cid/article/73/7/e2077/5983890},\r\nvolume = {73},\r\nyear = {2021}\r\n}\r\n","author_short":["Reddy, K. 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