PMID: 9164378May 26, 1997Paper

The cost-effectiveness of preventing tuberculosis in physicians using tuberculin skin testing or a hypothetical vaccine

Archives of Internal Medicine
M D NettlemanM C Roy

Abstract

Tuberculin skin testing using the purified protein derivative is recommended as part of a tuberculosis control program for health care workers. However, compliance with skin testing programs has been poor and their cost-effectiveness is unknown. A Markov-based decision analysis was performed to determine the cost-effectiveness of tuberculin skin testing over the entire lifetimes of physicians who are now in medical school. Assumptions were deliberately chosen to present a conservative estimate of cost-effectiveness. Indirect costs were not included. Annual testing cost $29,000 per life-year saved and $39,000 per case of pulmonary tuberculosis prevented. In contrast, particulate respirators have been shown to cost millions of dollars per case prevented. Skin testing every 6 months was cost-effective in a subpopulation at high risk of infection (> or = 1.8-fold). During their entire lifetimes, physicians now in medical school can expect to avert 137 cases of pulmonary tuberculosis, prevent 7 tuberculosis deaths, and save 182 life-years because of skin testing programs. Improved compliance with annual skin testing and prophylactic isoniazid could more than triple this benefit. If available, a moderately effective vaccine would be ...Continue Reading

Citations

Dec 10, 2013·The Pan African Medical Journal·Aliasghar FaraziMasoome Sofian
Dec 29, 2004·Revue des maladies respiratoires·C Chouaid
Mar 30, 2016·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Maria KoufopoulouLavanya Diwakar
Dec 23, 2006·The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine·Gerald F KominskiChi Chiao
Jul 29, 2000·Australian and New Zealand Journal of Medicine·R L Stuart, M L Grayson
Dec 3, 2003·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Lauren LambertRandall Reves
Mar 3, 2012·Expert Review of Vaccines·Hong-Anh T TuMaarten J Postma

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