Cost effectiveness analysis of implementing tuberculosis screening among applicants for non-immigrant U.S. work visas

Table 3 Estimated total annual economic costs for tuberculosis screening of nonimmigrant visa applicants, by program and country

	India (N = 102,909)		Mexico (N = 81,439)
	No screening	Screening	No screening	Screening
NIV time costs	$1,924,937	$23,300,164	$135,841	$2,026,805
NIV out-of-pocket costs	$31,694	$1,562,287	$4167	$7,756,105
Hospitalization costs	$2,414,143	$317,543	$557,442	$38,758
PHDs’ treatment costs	$999,064	$383,877	$343,637	$70,249
PHDs’ follow-up (Class B1)		$492,898	–	$259,781
Employer-forfeited visa/recruitment costs		$189,118	–	$0
Total costs (U.S. and international)	$5,369,838	$26,245,885	$1,041,087	$10,151,698
Total U.S. costs	$5,369,838	$2,213,938	$1,041,087	$442,350
Net multinational costs (U.S. and international)		$20,876,047		$9,110,611
Cost savings to the U.S.		$3,155,900		$598,737
# of U.S. TB cases	224	86	52	11
# of hospitalizations	110	14	25	2
Incremental cost-effectiveness ratio		$151,388		$221,088

Notes: NIV Non-immigrant visa applicants, PHDs Public health departments, U.S. United States
Out-of-pocket costs include worker transportation and forfeited visa fees paid by applicants in the United States, and panel physician exam fees paid by applicants in their home countries
Class B1 indicates persons who have an abnormal chest radiograph during panel physician screening exams
ICER = Incremental Cost-effectiveness Ratio (computed by dividing the difference in costs by the difference in effects)
Totals may not sum up exactly because of rounding effects