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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

From: A cost-benefit analysis of a proposed overseas refugee latent tuberculosis infection screening and treatment program

 

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

  1. LTBI latent tuberculosis infection, TST tuberculin skin test; U.S. United States, VSL value of a statistical life
  2. aValues reported in 2012 U.S. dollars
  3. 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
  4. cProportion TST positive