Cost-effectiveness of Tuberculosis Evaluation and Treatment for Immigrants
Author Information
Author(s): Porco Travis C, Lewis Bryan, Marseille Elliot, Grinsdale Jennifer, Flood Jennifer M, Royce Sarah E
Primary Institution: California Department of Health Services, Tuberculosis Control Branch
Hypothesis
Is domestic follow-up by local health jurisdictions of patients identified as suspected cases overseas a good public health investment?
Conclusion
Domestic follow-up of B-notification patients, including LTBI treatment, is highly cost-effective.
Supporting Evidence
- Domestic follow-up of B-notification patients can reduce new tuberculosis cases by about 6–26 per year.
- The program yielded 8 net QALYs and $25,000 in net savings.
- Treatment of individuals in class TB4 was found to be cost-saving.
Takeaway
This study shows that checking and treating immigrants for tuberculosis after they arrive in the U.S. is a smart way to save money and keep people healthy.
Methodology
A stochastic simulation model was used to evaluate the cost-effectiveness of follow-up and treatment for a hypothetical cohort of 1000 immigrants over 20 years.
Potential Biases
The model's assumptions may not fully capture the variability in TB progression and treatment outcomes.
Limitations
The study did not include indirect costs such as lost productivity and did not account for individuals with HIV infection.
Participant Demographics
The target population was legal immigrants to the United States.
Digital Object Identifier (DOI)
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