Cost-effectiveness of Using Quantiferon Gold (QFT-G)® versus Tuberculin Skin Test (TST) among U.S. and Foreign Born Populations at a Public Health Department Clinic with a Low Prevalence of Tuberculosis

• Published in: Public health Nursing 2014-03, Vol.31 (2), p.144-152
• Main Authors: Iqbal, Ayesha Z., Leighton, Jenelle, Anthony, John, Knaup, Richard C., Peters, Eleanor B., Bailey, Thomas C.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Comparative analysis; Cost-Benefit Analysis; Cost-effectiveness; Emigration and Immigration - statistics & numerical data; Female; Health care expenditures; Humans; LTBI; Male; Medical screening; Middle Aged; Nursing; Prevalence; Public health; Public Health - economics; screening; Sensitivity and Specificity; TST; Tuberculin Test - economics; Tuberculin Test - methods; Tuberculosis; Tuberculosis - diagnosis; Tuberculosis - epidemiology; United States - epidemiology; Young Adult
• ISSN: 0737-1209; 1525-1446
• DOI: 10.1111/phn.12083

Objective The purpose of this study was to determine the cost benefit to routinely using QFT‐G versus the standard TST for screening U.S. and foreign born populations at a public health department clinic with a low prevalence of tuberculosis. Design and Sample A comparative cost analysis of the monetization between QFT‐G and TST was conducted: Data from the health department's Chest Clinic patients seen in 2007 were used to model cost predictions. Measures The net costs of screening, x‐rays, the standard 9 months of latent tuberculosis infection treatment, laboratory, and administration for U.S. born patients and foreign born patients were investigated. Results There are no apparent cost savings for U.S. born individuals, but due to the higher specificity of QFT‐G for foreign born BCG‐vaccinated individuals, there are unnecessary expenditures associated with the higher number of false positives incurred when using TST compared with QFT‐G on 1,000 foreign born individuals (69%, 18%). Conclusion QFT‐G is cost‐effective and should be used at local health department clinics that want to achieve savings in screening and treating those suspected of having TB infection, especially for high‐risk populations such as foreign born individuals.