Revisiting annual screening for latent tuberculosis infection in healthcare workers: a cost-effectiveness analysis

Table 4 Cost-effectiveness of six TB screening strategies for a cohort of 1000 healthcare workers over 20 years: base-case scenario

Strategy	Cost in 2015 $Can	Incremental cost	QALYs	Increment in QALYs	Incremental cost per QALY gained^a	New active TB cases	Increment in active TB cases prevented	Incremental cost per additional TB case prevented^a
Post-exposure screening only
Tuberculin Skin Test	$66,387	—	15,239.98	––	––	3.03	—	—
QuantiFERON®-TB-Gold	$77,521	$11,134	15,239.85	–0.13	–– (Dominated^b)	2.97	0.06	$197,017
Targeted screening
Tuberculin Skin Test	$151,517	$85,130	15,237.96	–2.02	–– (Dominated^b)	2.83	0.14	$517,437^c
QuantiFERON®-TB-Gold	$263,660	$197,273	15,236.90	–3.07	–– (Dominated^b)	2.86	–0.04	— (Dominated^b)
Annual screening
Tuberculin Skin Test	$404,956	$338,569	15,231.85	–8.12	–– (Dominated^b)	2.68	0.15	$1,717,539
QuantiFERON®-TB-Gold	$817,695	$751,308	15,227.92	–12.06	–– (Dominated^b)	2.80	–0.12	— (Dominated^b)

TB tuberculosis, QALYs quality-adjusted life years
^aRelative to next most expensive, non-dominated strategy
^bDominated because it is more expensive and less effective than the proposed alternative; hence no incremental cost-effectiveness ratios are provided
^cIncremental cost of $426,678 per additional TB case prevented, relative to post-exposure TST screening only

ISSN: 1741-7015