TBC contact investigation in CR - current situation and proposed changes (cost-minimisation analysis).

Abstract

The study presents a cost-minimisation analysis of examination models for persons in contact with tuberculosis in the Czech Republic. The study draws on available cost data from the Czech Republic and clinical data from international studies.

It calculates costs of the MI model, which constitutes the current examination method for people in contact with TBC, with the use of tuberculin skin test (TST) and X-ray examination, the MII model, which uses in vitro release of interferon-gamma from blood cells (IGRA) and X-ray examination, and the MIII model, which is a two-step model using the confirmation of positive TST results by the IGRA test and X-ray examination. From the standpoint of social cost (direct and indirect) the MIII model (two-step with the use of TST and IGRA – CZK 21,186 / 10 examinations) is the least expensive.

This cost is however, almost identical to the cost necessary for the MII model (only IGRA – CZK 22,551 / 10 examinations), which is from the standpoint of examination technique.