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

Table 4 One-way sensitivity analyses of the costs of tuberculosis screening of nonimmigrant visa applicants: cost per estimated case averted by varying key parameters, by country

	India			Mexico
	Estimated U.S. cases prevented before U.S. arrival	U.S. Savings	ICER	Estimated U.S. cases prevented before U.S. arrival	U.S. savings	ICER
Base case	138	$3,155,900	$151,388	41	$598,737	$221,088
Proportion with clinical findings suggestive of TB^a (decreased by 50%)	69	1,577,950	299,463	21	$299,369	$452,715
Proportion with clinical findings suggestive of TB^a (increased by 50%)	NA^b	NA	NA	62	$898,106	$143,879
Proportion of B1 persons diagnosed domestically (reduced by 50%)	138	$2,777,095	$154,135	41	$558,045	$222,075
Proportion of B1 persons diagnosed domestically (increased by 50%)	138	$3,534,706	$148,641	41	$639,430	$220,100
Time spent on panel physician treatment in India or Mexico (reduced by 67% of baseline)	138	$3,155,900	$42,654	41	$598,737	$189,459
Time spent on panel physician treatment in India or Mexico (increased by 67% of baseline)	138	$3,155,900	$260,665	41	$598,737	$252,875
Opportunity costs excluded	138	$499,180	Cost saving	41	$528,421	$175,200

Notes: ICER Incremental Cost-effectiveness Ratio, U.S. United States
^aIn the model, individuals without clinical findings suggestive of TB do not go on to sputum culture/smear testing. If we assume that same rates of diagnosis (active TB) both overseas and at domestic follow-up for immigrants and NIVs, then this single parameter affects both the number of TB cases diagnosed overseas and the number of B1s. See Appendix Section A3 for details
^bWe did not evaluate a 50% increase for Indian NIVs because this did not seem plausible given

ISSN: 2200-6133