Incremental cost-effectiveness ratios (US$ per life year saved) | |||||
No test | TST | IGRA after (+) TST | IGRA after (−) TST | IGRA | |
0–2-year-old cohort base-case estimates | 1* | (Dominated) | (Dominated) | (Dominated) | (Dominated) |
LTBI rates (%) | |||||
8 | 1* | (Dominated) | (Dominated) | (Dominated) | (Dominated) |
48 | 1* | (Dominated) | (Dominated) | 183812 (QFT), 246342 (TSPOT) | (Dominated) |
TST sensitivity | |||||
75 | 1* | (Dominated) | (Dominated) | 1532062† (QFT), 1456062†(TSPOT) | (Dominated)† |
93 | 1* | (Dominated) | (Dominated) | (Dominated) | (Dominated) |
TST specificity | |||||
62 | 1* | (Dominated) | (Dominated) | (Dominated)‡ | (Dominated)‡ |
88 | 1* | (Dominated) | (Dominated) | (Dominated) | (Dominated) |
QFT sensitivity | |||||
75 | 1* | (Dominated) | (Dominated) | (Dominated) | (Dominated) |
92 | 1* | (Dominated) | (Dominated) | (Dominated) | (Dominated) |
QFT specificity | |||||
78 | 1* | (Dominated) | (Dominated) | (Dominated) | (Dominated) |
100 | 1* | (Dominated) | (Dominated) | (Dominated) | (Dominated) |
3–5 year old cohort Base-case estimates | 1* | (Dominated) | (Dominated) | 2335262 (QFT), 2542432 (TSPOT) | (Dominated) |
LTBI rates (%) | |||||
23 | 1* | (Dominated) | (Dominated) | (Dominated) | (Dominated) |
62 | 1* | (Dominated) | (Dominated) | 681222 (QFT) 752982 (TSPOT) | (Dominated) |
TST sensitivity | |||||
75 | 1* | (Dominated) | (Dominated) | 415682† (QFT), 451562† (TSPOT) | (Dominated)† |
93 | 1* | (Dominated) | (Dominated) | (Dominated) | (Dominated)† |
TST specificity | |||||
62 | 1* | (Dominated) | (Dominated) | 6154902† (QFT), 6782542†(TSPOT) | (Dominated)† |
88 | 1* | (Dominated) | (Dominated) | 1645502 †(QFT), 1796972†(TSPOT) | (Dominated)† |
QFT sensitivity | |||||
75 | 1* | (Dominated) | (Dominated) | 2303352 † (QFT), 252,8602 †(T-SPOT) | (Dominated)† |
92 | 1* | (Dominated) | (Dominated) | 2333262† (QFT), 2550652†(TSPOT) | (Dominated)† |
QFT specificity | |||||
78 | 1* | (Dominated) | (Dominated) | 2320232† (QFT), 2541562†(TSPOT) | (Dominated)† |
100 | 1* | (Dominated) | (Dominated) | 2320232† (QFT), 2541562†(TSPOT) | (Dominated)† |
↵* The superscript 1 indicates the most cost-effective strategy while 2 indicates a more effective, but less cost-effective strategy. Incremental cost-effectiveness ratios are provided for both types of IGRAs when the no-test strategy does not dominate.
↵† The single IGRA strategy is dominated by the IGRA after negative TST strategy. In all other instances, strategies are dominated by the no-testing strategy.
↵‡ Cost of IGRA after positive TST strategy becomes the most costly strategy. All strategies remain dominated by the no-testing strategy.
IGRA, interferon γ release assay; LTBI, latent tuberculosis infection; QFT, QuantiFERON assay, TSPOT, T-SPOT.TB; TST, tuberculin skin test.