Table 2.
Summary of eight cost-effectiveness studies
| Study period | Country | Study population | Outcome | Strategies | Results | |
|---|---|---|---|---|---|---|
| Pooran et al. [21] | 2 years | UK | Close contacts | Incremental costs/active TB case prevented | TST-only T-SPOT.TB-only TST+T-SPOT QFT-only TST+QFT |
₤ 47,840 ₤ 39,712 ₤ 37,206 ₤ 42,051 ₤ 37,699 |
| Marra et al. [22] | 20 years, 3% discounted |
Canada | Close contacts of foreign-born, non-aboriginal Canadian-born and aboriginal TB cases |
Incremental costs/QALY | QFT (BCG+) + TST (BCG-) TST+QFT (BCG+) +TST (BCG-) QFT (foreign-born, aboriginal, BCG+) +TST (BCG-) QFT (foreign-born and aboriginal) + TST (others) TST+QFT (foreign-born, aboriginal, BCG+) +TST (others) TST+QFT (foreign-born, ab-original) + TST (others) TST+QFT (all) QFT (all) |
Dominant Dominant CAD 31,930 CAD 40,433 CAD 135,672 Dominated Dominated CAD 79,443 |
| Oxlade et al. [23] | 20 years, 3% discounted |
Canada | Close and casual contacts | Incremental costs/case prevented | No screening TST QFT TST+QFT |
TST cost saving in close contacts (and casual contacts from low incidence countries) with exception of contacts receiving BCG after infancy (cost savings for QFT) |
| Immigrants | Incremental costs/case prevented | No screening CXR only TST only QFT only TST+QFT |
least expensive for subjects from high and intermediate incidence countries: CAD 875-30,680 Less expensive than QFT: CAD 46,600 (high incidence) -800,000 (intermediate) Most expensive: CAD 62, 643 (high incidence) 75, 777 (intermediate) Least expensive for subjects from low inci-dence countries): CAD 27,369-45,827 |
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| Kowada et al.[24] | Lifetime, 3% discounted |
Japan | Close contacts | Incremental costs/QALY | IGRA-only TST-only TST+IGRA |
$ 471.54 $ 573.98, dominated by IGRA-only $ 500.55, dominated by IGRA-only |
| de Perio et al. [25] | Lifetime, 3% discounted |
USA | HCWs with no BCG vaccination |
Incremental costs/QALY | QFT-IT QFT-G TST |
Not assessed $ 14,092 Dominated |
| HCWs with BCG vaccination |
QFT-IT QFT-G TST |
Not assessed $ 103,047 Dominated |
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| Deuffic-Burban et al. [26] | Lifetime, 3% discounted |
France | Close contacts | Incremental costs/LYG | No screening TST ≥ 10 mm +QFT QFT TST ≥ 5 mm |
€ 560 € 730 Strongly dominated |
| TST ≥ 5 mm +QFT TST ≥ 10 mm |
Weakly dominated Strongly dominated |
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| Diel et al. 2007 [27] | 20 years 3% discounted |
Germany | Close contacts | Incremental costs/LYG | No treatment TST > 5 TST > 10 QFT TST+QFT |
$ 30,170 dominant dominant dominant |
| Diel et al. [28] | 20 years, 3% discounted |
Switzerland | Close contacts in middle-aged group |
Incremental costs/LYG | TST > 5 mm TST > 10 mm TST > 15 mm T-SPOT-only TST+T-SPOT |
€ 141,502 € 107,151 € 44,831 € 23,692 € 23,692 |
| Young group | Incremental costs/LYG | TST > 5 mm TST > 10 mm TST > 15 mm T-SPOT-only TST+T-SPOT |
€ 96,705 € 70,955 € 26,451 € 11,621 € 11,621 |
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