Cost-effectiveness analysis of three interventions for the detection of tuberculosis cases in Santa Fe city, Argentina

Abstract

INTRODUCTION: The active finding of tuberculosis (TB) cases can be cost-effective due to the great potential long-term
benefits of preventing new cases, shortening the duration of morbidity and minimizing the risk of death. The objective of the study was to evaluate the cost-effectiveness of three strategies to detect pulmonary TB (pTB) cases among residents of 15 years  and older (≥15) of Santa Fe city, during one-year period. METHODS: Based on primary and secondary data sources, and  on the design and application of a static decision analytical model to evaluate the incremental cost-effectiveness ratio (ICER),  active case finding in the community (ACF) and household contact investigation (HCI) were compared with the passive case  finding (PCF) used as a regular practice in the context of TB control programs in Argentina. RESULTS: The number of pTB true  cases captured by PCF in a year was 55 for the total population of the city (17 per 100,000), at an average cost of USD 2625.62  per case. The additional benefit of adding the HCI to the PCF was 4 cases, at a cost of USD 9518.62 per additional case detected.  The addition of the ACF to the PCF+HCI strategy did not produce an additional benefit in terms of cases, although it had an  additional cost of USD 139.26. DISCUSSION: According to the adopted decision threshold, the PCF+HCI strategy qualified as very  cost-effective, in addition to being more cost-effective than the PCF+HCI+ACF strategy