Strategy | Cost ($) | Incremental costs ($) | QALYs | Incremental QALYs | ICER ($/QALY) |
---|---|---|---|---|---|
Sensitivity analysis 1 | |||||
TST | 816 | – | 17.641 | – | |
TST only | 822 | 6 | 17.643 | 0.0019 | 3082 |
Dual-test strategy | 1026 | 204 | 17.659 | 0.0157 | 13 023 |
Sensitivity analysis 2 | |||||
TST positive, IGRA | 742 | – | 17.623 | – | |
TST only | 827 | 84 | 17.637 | 0.0144 | 5858 |
Dual-test strategy | 928 | 101 | 17.654 | 0.0166 | 6078 |
Sensitivity analysis 3 | |||||
TST positive, IGRA | 785 | – | 17.641 | – | |
Dual-test strategy | 936 | 151 | 17.659 | 0.0176 | 8598 |
Dominated strategies are excluded. All costs are in Singapore dollars ($).
Sensitivity analysis 1: varied IGRA sensitivity=0.89; IGRA specificity=0.95; TST sensitivity=0.85; TST specificity=0.8; IGRA cost=$156; TST cost=$22 (meta-analyses15).
Sensitivity analysis 2: varied IGRA sensitivity=0.64; IGRA specificity=0.995; TST sensitivity=0.69; TST specificity=0.74; IGRA cost=$66; TST cost=$22 (prospective data).
Sensitivity analysis 3: varied from analysis 1 with IGRA cost=$66; TST cost=$22.
Dual-test strategy, TST and IGRA tests performed simultaneously; ICER, incremental cost-effectiveness ratio; IGRA, interferon-γ release assay; QALY, quality-adjusted life year; TST, tuberculin skin test; TST positive, IGRA, IGRA following a positive TST result strategy.