Table 4.
Sensitivity Analysis of the Net Benefit or Cost and Cases of TB Prevented from Implementing Overseas LTBI Screening in 100,000 U.S.- Bound Refugeesa,b
| LTBI Prevalence | ||||||
|---|---|---|---|---|---|---|
| High (55 %)c | Moderate (35 %)c | Low (20 %)c | ||||
| Net benefit (Cost) | Cases prevented | Net benefit (Cost) | Cases prevented | Net benefit (Cost) | Cases prevented | |
| Parameter | ||||||
| Rifapentine price doubled | $2,254,000 | 440 | ($56,000) | 220 | ($1,767,000) | 57 |
| Overseas TST $3.50 | $5,121,000 | 440 | $1,899,000 | 220 | ($488,000) | 57 |
| Overseas TST $5.15 | $4,956,000 | 440 | $1,734,000 | 220 | ($703,000) | 57 |
| 98 % TST specificity | $5,397,000 | 440 | $2,405,000 | 220 | $189,000 | 57 |
| 60 % TST specificity | $4,419,000 | 440 | $829,000 | 440 | ($1,830,000) | 57 |
| 77 % acceptance rate 3HP overseas | $3,758,000 | 323 | $1,286,000 | 161 | ($546,000) | 42 |
| 82 % completion of 3HP overseas | $4,025,000 | 360 | $1,383,000 | 180 | ($597,000) | 47 |
| 91 % acceptance rate in U.S. | $4,772,000 | 413 | $1,680,000 | 207 | ($610,000) | 54 |
| 91 % completion of 3HP in U.S. | $4,843,000 | 423 | $1,713,000 | 212 | ($606,000) | 55 |
| No discounting of cost or benefits | $7,732,000 | 590 | $3,155,000 | 295 | ($237,000) | 76 |
| VSL Included | $132,707,000 | 440 | $65,641,000 | 220 | $15,964,000 | 57 |
| Screen overseas and treat in U.S. | $1,463,000 | 165 | $288,000 | 83 | ($584,000) | 21 |
| Treat with isoniazid in U.S. | $4,493,000 | 458 | $1,513,000 | 229 | ($694,000) | 59 |
LTBI latent tuberculosis infection, TST tuberculin skin test; U.S. United States, VSL value of a statistical life
aValues reported in 2012 U.S. dollars
bA net benefit indicates that implementing overseas screening and treatment results in cost-savings while figures enclosed in parentheses indicate that there is an additional cost associated with overseas screening and treatment
cProportion TST positive