Cost-effectiveness of Using Quantiferon Gold (QFT-G)® versus Tuberculin Skin Test (TST) among U.S. and Foreign Born Populations at a Public Health Department Clinic with a Low Prevalence of Tuberculosis

Authors

  • Ayesha Z. Iqbal M.B.B.S., M.P.H.,

    Corresponding author
    1. St Louis County Department of Health, Communicable Disease Control Services Division (CDCS), Berkeley, Missouri
    • Correspondence to:

      Ayesha Z. Iqbal, St Louis County Department of Health, Division of Communicable Disease Control, 6121 N. Hanley Road, Berkeley, MO 63134. E-mail: aiqbal@stlouisco.com

    Search for more papers by this author
  • Jenelle Leighton R.N., B.S.N.,

    1. St Louis County Department of Health, Communicable Disease Control Services Division (CDCS), Berkeley, Missouri
    Search for more papers by this author
  • John Anthony M.T. (A.S.C.P.) C.I.C.,

    1. St Louis County Department of Health, Communicable Disease Control Services Division (CDCS), Berkeley, Missouri
    Search for more papers by this author
  • Richard C. Knaup B.S.,

    1. St Louis County Department of Health, Communicable Disease Control Services Division (CDCS), Berkeley, Missouri
    Search for more papers by this author
  • Eleanor B. Peters M.S.P.H., M.S.,

    1. St Louis County Department of Health, Communicable Disease Control Services Division (CDCS), Berkeley, Missouri
    Search for more papers by this author
  • Thomas C. Bailey M.D.

    1. Washington University School of Medicine, St Louis, Missouri
    Search for more papers by this author

Abstract

Objective

The purpose of this study was to determine the cost benefit to routinely using QFT-G versus the standard TST for screening U.S. and foreign born populations at a public health department clinic with a low prevalence of tuberculosis.

Design and Sample

A comparative cost analysis of the monetization between QFT-G and TST was conducted: Data from the health department's Chest Clinic patients seen in 2007 were used to model cost predictions.

Measures

The net costs of screening, x-rays, the standard 9 months of latent tuberculosis infection treatment, laboratory, and administration for U.S. born patients and foreign born patients were investigated.

Results

There are no apparent cost savings for U.S. born individuals, but due to the higher specificity of QFT-G for foreign born BCG-vaccinated individuals, there are unnecessary expenditures associated with the higher number of false positives incurred when using TST compared with QFT-G on 1,000 foreign born individuals (69%, 18%).

Conclusion

QFT-G is cost-effective and should be used at local health department clinics that want to achieve savings in screening and treating those suspected of having TB infection, especially for high-risk populations such as foreign born individuals.

Ancillary