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Table 3 Base case analysis: Cost-effectiveness of screening 21 year-old travelers for 3-month trips

From: Tuberculosis screening of travelers to higher-incidence countries: A cost-effectiveness analysis

Traveler's destination Traveler group: Annual risk of infection Screening strategy from least to most expensive

Expected costs per 1,000 (2005 USD)

Expected cases per 1,000

Incremental cost per 1,000†

Incremental cases prevented per 1,000†

Incremental cost per case prevented†

Travelers to Mexico

     

US-born: Annual infection risk 0.3%

     

   No screening

$7,428

1.0

-

-

-

   Post-trip TST

$47,082

0.8

$39,654

0.2

$161,196

   Post-trip chest x-ray

$58,972

0.9

$11,890

(0.1)

Dominated

   Pre & post trip TST; treatment for reactors

$68,644

0.8

$9,672

0.1

Dominated

   Pre & post trip TST; treatment for converters only

$68,741

0.9

$97

(0.1)

Dominated

Mexican-born: Annual infection risk 0.3%

     

   No screening

$9,855

1.3

-

-

-

   Post-trip TST

$57,666

1.0

$47,811

0.3

$143,578

   Post-trip chest x-ray

$61,087

1.1

$3,421

(0.1)

Dominated

   Pre & post trip TST; treatment for converters only

$71,335

1.2

$10,248

(0.1)

Dominated

   Pre & post trip TST; treatment for reactors

$74,372

1.1

$3,037

0.1

Dominated

Travelers to Dominican Republic

     

US-born: Annual infection risk 0.8%

     

   No screening

$13,226

1.7

-

-

-

   Post-trip TST

$51,961

1.3

$38,735

0.4

$102,745

   Post-trip chest x-ray

$64,678

1.6

$12,718

(0.3)

Dominated

   Pre & post trip TST; treatment for reactors

$73,792

1.4

$9,114

0.2

Dominated

   Pre & post trip TST; treatment for converters only

$73,889

1.5

$97

(0.1)

Dominated

Dominican-born: Annual infection risk 0.8%

     

   No screening

$25,423

3.3

-

-

-

   Post-trip TST

$73,523

2.6

$48,100

0.7

$65,264

   Post-trip chest x-ray

$75,711

2.9

$2,188

(0.3)

Dominated

   Pre & post trip TST; treatment for reactors

$86,604

2.8

$10,893

0.1

Dominated

   Pre & post trip TST; treatment for converters only

$89,568

3.2

$2,964

(0.4)

Dominated

Travelers to Haiti

     

US-born: Annual infection risk 2.6%

     

   No screening

$34,041

4.4

-

-

-

   Post-trip TST

$68,756

3.5

$34,715

0.9

$36,931

   Post-trip chest x-ray

$85,163

4.3

$16,407

(0.8)

Dominated

   Pre & post trip TST; treatment for reactors

$91,797

3.8

$6,634

0.5

Dominated

   Pre & post trip TST; treatment for converters only

$91,893

3.9

$96

(0.1)

Dominated

Haitian-born: Annual infection risk 2.6%

     

   No screening

$73,594

9.6

-

-

-

   Post-trip chest x-ray

$119,983

8.5

$46,389

1.1

$40,585*

   Post-trip TST

$121,073

7.4

$1,090

1.1

$1,014

   Pre & post trip TST; treatment for reactors

$133,556

8.1

$12,484

(0.7)

Dominated

   Pre & post trip TST; treatment for converters only

$135,395

9.2

$1,839

(1.1)

Dominated

  1. †For each type of traveler, strategies are listed by increasing cost. In the three rightmost columns, the calculation of incremental values (e.g., incremental cost per 1,000) is based on the comparison between each strategy and its next least costly alternative (e.g., a row might show the difference in cost between the second least costly strategy and the least costly strategy; the next row below would then show the cost difference between the third and second least costly strategies; and so on). Values in parentheses indicate an increase in expected cases, instead of cases prevented. "Dominated" means that another strategy is available that is both less costly and effective in preventing more TB cases.
  2. *Dominated by extended dominance. While post-trip chest X-ray is the least costly option, another choice is available which is more attractive on an incremental cost per case prevented basis. The incremental cost per TB case prevented of post-trip TST, compared to no screening, is $21,406.