Economic Evaluation of Diagnosis and Treatment for Latent Tuberculosis Infection Among Contacts of Pulmonary Tuberculosis Patients in Thailand

Overview

Journal Sci Rep

Specialty Science

Date 2024 Jul 31

PMID 39085338

Authors

Panida Yoopetch

Olivia Wu

Jiraphun Jittikoon

Montarat Thavorncharoensap

Sitaporn Youngkong

Naiyana Praditsitthikorn

Surakameth Mahasirimongkol

Thunyarat Anothaisintawee

Wanvisa Udomsinprasert

Usa Chaikledkaew

Affiliations

Soon will be listed here.

Abstract

Currently, interferon-gamma release assay (IGRA) is costly and not included as latent tuberculosis infection (LTBI) screening test strategy in Thailand's Universal Coverage Scheme (UCS) benefit package. The objective of this study was to assess the cost-utility of LTBI screening strategies among tuberculosis (TB) contacts in Thailand. A hybrid decision tree and Markov model was developed to compare the lifetime costs and health outcomes of tuberculin skin test (TST) and IGRA, in comparison to no screening, based on a societal perspective. Health outcomes were the total number of TB cases averted and quality-adjusted life years (QALYs), with results presented as an incremental cost-effectiveness ratio (ICER). One-way and probabilistic sensitivity analyses were performed to explore uncertainties in all parameters. The ICER of TST compared with no screening was 27,645 baht per QALY gained, while that of IGRA compared to TST was 851,030 baht per QALY gained. In a cohort of 1000 TB contacts, both TST and IGRA strategies could avert 282 and 283 TB cases, respectively. At the Thai societal willingness-to-pay threshold of 160,000 baht per QALY gained, TST was deemed cost-effective, whereas IGRA would not be cost-effective, unless the cost of IGRA was reduced to 1,434 baht per test.

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