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Volume 25, Number 4—April 2019

Cost-effectiveness of Latent Tuberculosis Infection Screening before Immigration to Low-Incidence Countries

Jonathon R. Campbell, James C. Johnston, Victoria J. Cook, Mohsen Sadatsafavi, R. Kevin Elwood, and Fawziah MarraComments to Author 
Author affiliations: University of British Columbia, Vancouver, British Columbia, Canada (J.R. Campbell, J.C. Johnston, V.J. Cook, M. Sadatsafavi, R.K. Elwood, F. Marra); British Columbia Centre for Disease Control, Vancouver (J.C. Johnston, V.J. Cook, R.K. Elwood)

Main Article

Table 3

Cost and QALY estimates and values used for sensitivity analysis of intervention strategies for screening and treatment of latent TB infection in immigrants*

Parameter Estimate, $ Range evaluated in PSA PSA distribution References
Full INH treatment 992 804–1179 Triangular, 804–1179 BCCDC, (33,36)
Drug costs 181
Nurse and clinician costs 741
Follow-up chest radiograph 42
Routine tests 28
Full RIF treatment 575 464–686 Triangular, 464–686 BCCDC, (33,36)
Drug costs 98
Nurse and clinician costs 421
Follow-up chest radiograph 42
Routine tests 14
Partial INH 462 174–804 Triangular, 174–804 BCCDC, (33,36)
Partial RIF 319 178–464 Triangular, 178–464 BCCDC, (33,36)
Complete TST 31 24–38 Triangular, 24–38 BCCDC, (33,36)
TST cost 11
Nurse costs (2 visits) 20
Incomplete TST 21 17–25 Triangular, 17–25 BCCDC, (33,36)
IGRA 54 31–62 Triangular, 31–62 BCCDC, (33,36)
Kit and technician cost 47
Nurse costs 7
Chest radiograph 42 32–52 Triangular, 32–52 BCCDC, (33,36)
Cost per radiograph 35
Nurse costs 7
TB 20,532 7141–39,525 Gamma(4.1064,5,000) Expert opinion, (33,34)
LTBI adverse event 732 549–916 Triangular, 549–916 (33)
Hospitalization 6,641 5305–9985 Triangular, 5,305–9,985 (30)
Triangular, 13,079–40,788
LTBI 0.81 Assumed (38)
Healthy 0.81 0.58–0.97 Beta(7.85,1.84) (38)
Adverse event disutility 0.2 0.15–0.25 Triangular, ±25% (30,33)
TB 0.69 0.08–0.24† Beta(9,51) (38)
Hospitalization 0.5 0.28–0.51† Beta(19.5,30.5) (30)
Death 0 Fixed Fixed Standard

*All costs are in 2016 Can $. BCCDC, British Columbia Centre for Disease Control; IGRA, interferon-gamma release assay; INH, isoniazid; LTBI, latent tuberculosis infection; PSA, probabilistic sensitivity analysis; RIF, rifampin; TB, tuberculosis; TST, tuberculin skin test.
†Sampled as a percent decrement compared to healthy QALY.

Main Article

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