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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

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

Strategy Cost in 2015 $Can Incremental cost QALYs Increment in QALYs Incremental cost per QALY gaineda New active TB cases Increment in active TB cases prevented Incremental cost per additional TB case preventeda
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 — (Dominatedb) 8.73 0.17 — (Extended dominancec)
Targeted screening
 Tuberculin Skin Test $257,670 $59,190 15,232.84 –1.22 — (Dominatedb) 8.18 0.55 $52,552
 QuantiFERON®-TB-Gold $365,397 $166,917 15 231.90 –2.15 — (Dominatedb) 8.23 –0.05 — (Dominatedb)
Annual screening
 Tuberculin Skin Test $487,837 $289,357 15,227.38 –6.68 — (Dominatedb) 7.64 0.54 $426,678
 QuantiFERON®-TB-Gold $868,662 $670,182 15,223.94 –10.11 — (Dominatedb) 7.95 –0.31 — (Dominatedb)
  1. TB tuberculosis, QALYS quality-adjusted life years
  2. aRelative to next most expensive, non-dominated strategy
  3. bDominated because it is more expensive and less effective than the proposed alternative; hence no ICER is provided
  4. 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