ArticleBMC health services research2026
Cost-effectiveness of latent tuberculosis infection testing and preventive treatment among TB contacts in China: a Markov model.
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThis study evaluates the costs and cost-effectiveness of latent tuberculosis infection (LTBI) testing and preventive treatment (TPT) strategies among close contacts of active tuberculosis (ATB) patients in China using a Markov model, with the aim of informing the optimization of national TPT strategies.
methodsA Markov model was developed to evaluate the cost-effectiveness of LTBI testing with purified protein derivative (PPD), Mycobacterium TB antigen-based skin test (TBST), or interferon-gamma release assay (IGRA), each followed by either a 4-week thrice-weekly rifapentine plus isoniazid regimen (1 H3P3) or a 3-month twice-weekly rifapentine plus isoniazid regimen (3 H2P2), in a hypothetical cohort of 10,000 close contacts of ATB patients with a mean age of 38 years. The primary outcome was the incremental cost-effectiveness ratio (ICER), expressed as cost per quality-adjusted life years (QALY) gained, and strategies were judged against China’s 2024 per-capita GDP–based willingness-to-pay (WTP) threshold (¥95,754 per QALY).
resultsIn the base-case analysis, LTBI testing with TBST or IGRA followed by treatment with 1 H3P3 was the dominant strategy. Specifically, LTBI testing with TBST followed by 1 H3P3 resulted in a cost of ¥8,367.79 (95% UI: ¥-76549.62, ¥79,656.24) per QALY gained, which is below WTP threshold. Sensitivity analysis indicated that LTBI prevalence and utility values assigned to cure ATB or self-healing in ATB substantially influenced incremental cost-effectiveness ratios.
conclusionLTBI testing with TBST followed by treatment with 1 H3P3 is a cost-effective strategy and may represent an optimum for tuberculosis control among close contacts of ATB patients in China.
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