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Eur Respir J 2006, doi:10.1183/09031936.06.00005906
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ORIGINAL ARTICLE |
Direct costs of three models for the screening of latent tuberculosis infection
1 Oxford Immunotec, Oxford (UK)
2 University Medical Policlinic, Lausanne (Switzerland)
* To whom correspondence should be addressed. E-mail: Jean-Pierre.Zellweger{at}hospvd.ch.
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Abstract |
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To compare the direct costs of three models for detection of latent TB infection (LTBI) in routine clinical practice in Switzerland
Comparison of the overall costs of screening for LTBI, including medical and radiological examination, and preventive treatment associated with three screening models. Model 1 relies only on the tuberculin skin test (TST) as per the current national guidelines, Model 2 on T-SPOT.TB only and Model 3 on TST followed by confirmation of positive results by T-SPOT.TB. Costs were taken directly from the clinic's figures. Clinical assumptions were based on the 267 patients who were referred to the clinic over the study period.
Model 3 was the most cost-effective. Using only the skin test (Model 1) was the least cost-effective. If only one test for LTBI is used, then Model 2 (using T-SPOT.TB only) is cheaper than using the TST (Model 1).
Screening for LTBI by TST followed by confirmation with T-SPOT.TB is less costly than screening with TST alone, as it allows a reduction in the number of people who receive preventive treatment. In groups with a high proportion of negative TSTs, screening with T-SPOT.TB test only may be the most cost-effective.
Keywords: Contact tracing, interferon-gamma release assays, latent tuberculosis infection, screening, tuberculosis
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