Cost-effectiveness of expanded latent TB infection testing and treatment: Lynn City, Massachusetts, USA

Details

• Alternative Title:
  Int J Tuberc Lung Dis
• Personal Author:
  Asay, G. R. Beeler ; Woodruff, R. ; Sanderson, D. M. ; Fisher, C. F. ; Marks, S. M. ; Green, V. D. ; Tibbs, A. M. ; Hill, A. N. ; Haptu, H. H. ; McManus, D. ; Paradise, R. K. ; Auguste-Nelson, C. ; Cochran, J. J.
• Description:
  BACKGROUND:
  
  Between October 2016 and March 2019, Lynn Community Health Center in Massachusetts implemented a targeted latent TB infection testing and treatment (TTT) program, increasing testing from a baseline of 1,200 patients tested to an average of 3,531 patients tested, or 9% of the population per year.
  
  METHODS:
  
  We compared pre-implementation TTT, represented by the first two quarters of implementation data, to TTT, represented by 12 quarters of data. Time, diagnostic, and laboratory resources were estimated using micro-costing. Other cost and testing data were obtained from the electronic health record, pharmaceutical claims, and published reimbursement rates. A Markov cohort model estimated future health outcomes and cost-effectiveness from a societal perspective in 2020 US dollars. Monte Carlo simulation generated 95% uncertainty intervals.
  
  RESULTS:
  
  The TTT program exhibited extended dominance over baseline pre-intervention testing and had an incremental cost-effectiveness ratio (ICER) of US$52,603 (US$22,008–US$95,360). When compared to baseline pre-TTT testing, the TTT program averted an estimated additional 7.12 TB cases, 3.49 hospitalizations, and 0.16 deaths per lifetime cohort each year.
  
  CONCLUSIONS:
  
  TTT was more cost-effective than baseline pre-implementation testing. Lynn Community Health Center’s experience can help inform other clinics considering expanding latent TB infection testing.
  
  
• Subjects:
  Cost-Benefit Analysis Hospitalization Humans Latent Tuberculosis Massachusetts Tuberculosis
• Keywords:
  Cost-effectiveness Economic Evaluation LTBI Testing Tuberculosis
• Source:
  Int J Tuberc Lung Dis. 28(1):21-28
• Pubmed ID:
  38178297
• Pubmed Central ID:
  PMC11149049
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  28
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:8155c0a90000fe93eac1e282ff8a60c972969f99a0fe0a70ba1bd387029ed0ba4b00da9607da34244fa90cd340d030fc3f3f64232f2a71366a54391ec93b3df8
• Download URL:
  https://stacks.cdc.gov/view/cdc/175214/cdc_175214_DS1.pdf
• File Type:
  [PDF - 399.02 KB ]