Microscopic view of Tuberculosis bacteria with cost savings symbols

Early Tuberculosis Detection: Is Rapid Testing Worth the Cost?

Samir D’Costa in Health & Wellness December 2025 • 4 min read.

"A Spanish hospital study reveals the economic and clinical benefits of implementing rapid TB detection, offering insights into improved patient care and cost savings."

Tuberculosis (TB) remains a significant global public health challenge, exacerbated by the rise of drug-resistant strains. Rapid and accurate diagnosis is crucial to controlling the spread of infection and improving patient outcomes. Traditional methods, like baciloscopia and culture, have limitations in terms of speed and sensitivity, leading to delays in treatment and increased healthcare costs.

Molecular diagnostic techniques, such as the Xpert MTB/RIF® assay, offer a faster and more accurate alternative for detecting Mycobacterium tuberculosis complex (MTBC) and rifampicin resistance. While these advanced methods may have a higher initial cost, their potential to reduce hospital stays, prevent unnecessary treatments, and improve patient management makes them an attractive option.

A recent study conducted in a Spanish hospital aimed to evaluate the economic and clinical impact of introducing the Xpert MTB/RIF® assay for early TB detection. The study assessed the cost savings associated with reduced hospitalizations and avoided treatments, providing valuable insights into the potential benefits of implementing rapid TB testing in a clinical setting.

The Cost of Delayed TB Diagnosis: Understanding the Economic Burden

Microscopic view of Tuberculosis bacteria with cost savings symbols

The study focused on estimating the savings achieved by reducing the time patients spent in the hospital due to TB. Delays often arise from false negatives (when a test incorrectly shows a patient doesn't have TB) and false positives (when a test incorrectly indicates a patient has TB) using traditional baciloscopia methods. The implementation of Xpert testing aimed to correct these inaccuracies during the period of 2008-2012.

Researchers calculated costs by adding up expenses related to both false negatives (FN) and false positives (FP). For false negatives, this included the cost of extended hospital stays, specialized tests, and respiratory isolation measures. For false positives, costs included unnecessary anti-tuberculosis treatments, follow-up consultations, laboratory tests, and microbiological monitoring.

False Negatives (FN): Extended hospital stays, specialized tests (fibrobronchoscopies, CT scans), respiratory isolation.
False Positives (FP): Unnecessary anti-tuberculosis medication, follow-up consultations, liver function tests, microbiological controls.

Over the five-year study period, the hospital identified 19 false positives and 22 false negatives. Had Xpert been in place, it is estimated that it would have detected 19 of the false positives and 15 of the false negatives. The minimum estimated cost for managing the false positives totaled 3,217 euros (covering treatments, consultations, and lab work), while each false negative resulted in an average hospital stay extension of seven days, costing approximately 59,012 euros. In total, these inaccuracies led to an expense of 62,229 euros.

The Verdict: Improved Care and Cost Savings

The study concludes that implementing Xpert testing would not only lead to economic savings for the hospital but also enhance the quality of patient care by preventing unnecessary hospitalizations and treatments. By investing an initial 16,250 euros (based on testing 50 high-suspicion TB cases at 65 euros per test), the hospital could have saved a total of 45,979 euros over five years. This highlights the potential for rapid diagnostic techniques to optimize healthcare resource allocation while improving patient outcomes.

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This article is based on research published under:

DOI-LINK: 10.4321/s1135-57272013000400011, Alternate LINK

Title: Impacto Económico De La Introducción De Una Técnica De Detección Precoz De Mycobacterium Tuberculosis Complex En Las Muestras Clínicas De Un Hospital Español

Subject: General Medicine

Journal: Revista Española de Salud Pública

Publisher: SciELO Espana/Repisalud

Authors: María Ángeles Asencio Egea, María Huertas Vaquero, Rafael Carranza González, Jesús Castellanos Monedero, María Franco Huerta, José Manuel Bravo Nieto, José María Tenías Burillo

Published: 2013-08-01

Everything You Need To Know

What are the primary limitations of traditional methods like baciloscopia and culture in TB diagnosis?

Traditional methods such as baciloscopia and culture face limitations in speed and sensitivity. These methods often lead to delays in treatment due to the time required to obtain results and their potential for inaccurate diagnoses. This can result in extended hospital stays, unnecessary treatments, and increased healthcare costs. The delays in treatment can also contribute to the spread of the infection, complicating the control of TB outbreaks, which is a significant global public health challenge, especially given the rise of drug-resistant strains.

How does the Xpert MTB/RIF® assay improve upon traditional TB diagnostic methods?

The Xpert MTB/RIF® assay offers a faster and more accurate alternative to traditional methods like baciloscopia. It provides quicker results, allowing for rapid identification of Mycobacterium tuberculosis complex (MTBC) and detection of rifampicin resistance. This leads to quicker and more informed treatment decisions, which results in shorter hospital stays, reduced costs, and improved patient care. By rapidly identifying rifampicin resistance, the assay guides clinicians to the most effective treatments early on.

What specific costs were associated with false positives and false negatives in the Spanish hospital study?

The study in the Spanish hospital identified several costs associated with both false positives (FP) and false negatives (FN). For false negatives, the costs included extended hospital stays, specialized tests such as fibrobronchoscopies and CT scans, and respiratory isolation measures. For false positives, costs were related to unnecessary anti-tuberculosis medication, follow-up consultations, liver function tests, and microbiological controls. These inaccuracies collectively added to the financial burden on the healthcare system.

How did implementing the Xpert MTB/RIF® assay lead to cost savings and improved patient care?

Implementing the Xpert MTB/RIF® assay led to economic savings by reducing hospitalizations and preventing unnecessary treatments. The study showed that by reducing both false positives and false negatives, the hospital could minimize the costs associated with inaccurate diagnoses. This not only decreased financial burdens but also enhanced patient care by avoiding unnecessary treatments and ensuring quicker access to appropriate interventions. By investing in the Xpert testing, the hospital improved the allocation of healthcare resources, ultimately leading to better patient outcomes.

What was the total cost savings achieved by the Spanish hospital after implementing Xpert MTB/RIF® assay?

Based on the study, the Spanish hospital could have saved a total of 45,979 euros over five years by implementing the Xpert MTB/RIF® assay. This calculation considered the initial investment of 16,250 euros for testing 50 high-suspicion TB cases, and the subsequent savings from reduced hospital stays and avoided treatments due to more accurate and timely diagnoses. This demonstrates the significant potential of rapid diagnostic techniques to optimize healthcare resource allocation and improve patient outcomes in the context of TB management.