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

Table 5 Cost-effectiveness of six TB screening strategies for a cohort of 1000 healthcare workers over 20 years: alternate scenario with increased worker risk

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	$198,480	—	15,234.05	—	—	8.90	—	—
QuantiFERON®-TB-Gold	$228,809	$30,329	15,233.75	–0.30	— (Dominated^b)	8.73	0.17	— (Extended dominance^c)
Targeted screening
Tuberculin Skin Test	$257,670	$59,190	15,232.84	–1.22	— (Dominated^b)	8.18	0.55	$52,552
QuantiFERON®-TB-Gold	$365,397	$166,917	15 231.90	–2.15	— (Dominated^b)	8.23	–0.05	— (Dominated^b)
Annual screening
Tuberculin Skin Test	$487,837	$289,357	15,227.38	–6.68	— (Dominated^b)	7.64	0.54	$426,678
QuantiFERON®-TB-Gold	$868,662	$670,182	15,223.94	–10.11	— (Dominated^b)	7.95	–0.31	— (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 ICER is provided
^cExtended dominance by the targeted tuberculin skin testing screening strategy, meaning that the incremental cost-effectiveness ratio is in fact lower for the targeted tuberculin skin testing screening strategy, so the targeted strategy is preferred. Hence no ICER is provided

ISSN: 1741-7015