OBJECTIVES: Tuberculosis (TB) is associated with a substantial burden in China, with 780,000 new cases annually. A rapid NAA test was recently introduced in China, which simultaneously detects mycobacterium tuberculosis complex and rifampin resistance in <2 hours. We aimed to compare the HRU and costs associated with TB diagnosis using the NAA test vs. conventional tests only and to estimate the budget impact of introducing the NAA test for patients with TB symptoms from a hospital’s perspective in China.

METHODS: This retrospective cohort, designed by the Chinese Center for Disease Control and Prevention, included TB patients from 11 hospitals in China. The exposure was the use of the NAA test. The main outcomes included hospital length of stay (LOS), costs for diagnostic anti-inflammatory therapies, and TB diagnosis costs. The outcomes were compared using linear regressions controlling for potential confounders. Furthermore, a budget impact model (BIM) was built to assess the differences in total hospital costs before and after introducing the rapid NAA test. Model inputs were estimated using data from the retrospective cohort or published sources.

RESULTS: Among 991 TB patients, 370 patients diagnosed with the NAA test and 621 without. Compared to conventional tests, the adjusted average LOS was 0.7 days shorter, the adjusted average costs for diagnostic anti-inflammatory therapies were ¥1,592 lower, and the adjusted average TB diagnosis costs were ¥311 lower in TB patients diagnosed with the NAA test. In the base case of the BIM, 60,000 patients with TB symptoms were eligible for TB tests in a hypothetical population of 300,000 patients. Introducing the NAA test decreased hospital costs by ¥5.3 million annually.

CONCLUSIONS: Introducing the NAA test for TB diagnosis can reduce HRU and total costs for each patient and offer a budget-saving option from a hospital’s perspective in China.