Cost-effectiveness analysis of tuberculosis screening in diabetic patients in China
A decision-analytic Markov model
Bibliographic Data
| ID | 22072971 |
|---|---|
| Authors | Hui-Wen Song (Fujian Medical University), Yong Lin (0000-0002-5710-5036, Fujian Medical University), Tu-Er Wan (Fujian Medical University), Chen-Fan Zhang (Fujian Medical University), Jin‐Shui Pan (0000-0002-9586-7760, Fujian Medical University, corresponding author), Jin-Shui Pan |
| Year | 2026 |
| Volume | 13 |
| Pages | 1696952-1696952 |
| Publication date | 2026-01-05 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Frontiers in Public Health (JOURNAL) |
| Journal identifiers | ISSN: 2296-2565 • E-ISSN: 2296-2565 |
| Publisher | Frontiers Media SA (PUBLISHER • CH) |
| DOI | 10.3389/fpubh.2025.1696952 |
| PMID | 41561859 |
| OpenAlex | W7118163921 |
| Language | EN |
| References cited | 54 |
Objective: To establish a pharmacoeconomic model to evaluate the cost-effectiveness of various screening strategies for latent tuberculosis infection (LTBI) in older diabetic patients and provide evidence for health policy formulation. Methods: A decision tree-Markov model was constructed to simulate the LTBI screening process for 10,000 diabetic patients aged 60 years and older, analyzing the costs and health utilities of different screening strategies. Results: The incremental cost-effectiveness ratio (ICER) of the traditional tuberculin skin test (TST) strategy was significantly lower than the willingness-to-pay threshold, indicating its economic advantage. Meanwhile, the economic benefit of the new recombinant tuberculosis fusion protein skin test (C-TST) compared to TST was not significant, and the interferon-gamma release assay (IGRA) was considered the least cost-effective option due to its high cost. One-way sensitivity analysis identified key parameters that affect the economic viability of screening strategies, such as non-tuberculous mortality rates by age group, LTBI mortality rates, and annual medical costs associated with diabetes. When the non-tuberculous mortality rate reached a certain threshold, the economic viability of all screening strategies was impacted. Additionally, probabilistic sensitivity analysis indicated that TST had a high probability (70%) of being the most cost-effective screening option at a common willingness-to-pay threshold. Conclusion: Screening for LTBI in older diabetic patients is a cost-effective approach. The strategy should take into account economic conditions and healthcare resource allocation in various regions to enhance the effectiveness of public health interventions
Diabetes mellitus · Disease · Health care · Markov chain · Markov model · Public health · Tuberculosis · Diagnosis and treatment of tuberculosis · Infectious Diseases and Tuberculosis · Tuberculosis Research and Epidemiology
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| Highly cited | No |
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