Cost-effectiveness comparisons between different testing strategies and no testing for TB in people living with HIV assuming a 10% progression rate to active TB in people with a positive IGRA
Strategy | Total cost (per 10,000 PHIV in care) | Cases active TB prevented (per 10,000 PHIV in care) | Incremental cost/case averted (£) compared to no testing | Incremental cost/QALY gained (£) compared to no testing | Incremental cost/QALY gained compared to previous non-dominated algorithm |
---|---|---|---|---|---|
No testing | £473,137 | - | - | - | - |
BHIVA | £538,354 | 5.3 | £12,205 | £21,475 | £21,475 |
NICE | £616,246 | 3.7 | £38,720 | £74,790 | Dominated (simple) |
TST in all | £725,781 | 16.3 | £15,511 | £29,690 | Dominated (extended) |
IGRA in all | £892,330 | 14.2 | £29,571 | £52,033 | Dominated (simple) |
TST and IGRA in all | £1,100,608 | 16.7 | £37,525 | £72,943 | Dominated (extended) |
TST, IGRA and CXR in all | £1,486,154 | 27.5 | £36,902 | £73,558 | Dominated (extended) |
TST, IGRA, CXR and induced sputum in all | £1,920,744 | 36.6 | £39,587 | £79,929 | Dominated (extended) |