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Table 2 Estimated costs, TB cases prevented and cost-effectiveness for modeled scenarios of screening and treatment for latent tuberculosis infection among 15- to 34-year-old asylum seekers in Germany, 2022

From: Targeting screening and treatment for latent tuberculosis infection towards asylum seekers from high-incidence countries – a model-based cost-effectiveness analysis

LTBI screening threshold Total costs* (million €) TB cases prevented QALYs gained Incr. costs* (million €) Incr. TB cases prevented Incr. QALYs gained ICER (Thsd. € per TB case prevented) ICER (Thsd. € per QALY gained
≥ 250 0.31 (0.20–0.42) 16 (7–32) 7.3 (2.7–14.8) 0.31 (0.20–0.42) 16 (7–32) 7.3 (2.7–14.8) 22.3 (8.2–50.0) 51.0 (18.0–114.1)
≥ 200 0.56 (0.38–0.77) 29 (12–56) 13.2 (4.9–26.3) 0.25 (0.17–0.35) 13 (5–25) 5.8 (2.1–11.6) 23.3 (8.6–52.2) 53.3 (19.1–122.5)
≥ 150 1.10 (0.74–1.52) 56 (23–105) 24.9 (9.3–49.9) 0.54 (0.37–0.74) 26 (11–50) 11.8 (4.4–23.7) 24.5 (9.2–53.7) 55.9 (20.2–128.2)
≥ 100 1.19 (0.80–1.63) 60 (24–113) 26.6 (9.9–53.5) 0.09 (0.06–0.12) 4 (2–7) 1.7 (0.6–3.3) 27.1 (10.5–59.8) 62.0 (23.2–142.0)
≥ 50 1.66 (1.13–2.27) 75 (31–142) 33.6 (12.5–67.1) 0.47 (0.33–0.66) 16 (6–30) 6.9 (2.6–13.8) 36.0 (14.7–78.4) 82.4 (31.6–184.7)
≥ 20 2.04 (1.39–2.78) 84 (34–157) 37.7 (14.0–74.7) 0.38 (0.26–0.54) 9 (4–18) 4.1 (1.5–8.7) 48.7 (19.8–106.7) 111.8 (42.7–251.9)
None 2.91 (2.02–4.02) 100 (41–187) 44.8 (16.8–88.3) 0.87 (0.60–1.25) 16 (5–35) 7.1 (2.2–16.3) 68.0 (26.1–158.7) 156.3 (54.4–373.3)
  1. Intervals in brackets denote 95% uncertainty intervals. Latent tuberculosis infection (LTBI) screening thresholds shown denote levels of country-of-origin tuberculosis incidence above which asylum seekers would be eligible for LTBI screening and tuberculosis preventive treatment. Screening threshold alternatives are presented in the order of increasing cost, starting with the least costly screening scenario (≥250 incidence threshold). Increments for tuberculosis cases prevented, quality-adjusted life years (QALYs) gained and incremental cost-effectiveness ratios (ICER) were calculated with respect to the previous less costly alternative (i.e. ≥250 threshold compared to no screening, each of the other thresholds compared to the next higher threshold, “none” compared to the ≥20 threshold). *Costs incurred for LTBI screening and TPT are offset for discounted future savings of costs for the management of TB among those in whom TB was prevented - see main text. † No threshold was used; all individuals were eligible for screening regardless of country-of-origin TB incidence