. "Appendix 16: Mycobacterium tuberculosis." Vaccines for the 21st Century: A Tool for Decisionmaking. Washington, DC: The National Academies Press, 2000.
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Vaccines for the 21st Century: A Tool for Decisionmaking
Table A16–3 Health Care Costs Associated with TB Infection
% with Care
Cost per Unit
Units per Case
Form of Treatment
Asymptomatic—suspect
treated (detected in screening, etc.)
suspect cases: 3 months treatment until culture results available
100%
$50
2.0
physician a
100%
$25
3.0
nurse visit
100%
$50
1.0
diagnostic a
100%
$50
3.0
medication b
Asymptomatic—latent
treated (detected in screening, etc.)
75%
$50
3.0
physician a
preventive treatment for latent infection: 6 months
75%
$25
6.0
nurse visit
estimated 60% complete treatment; rest complete half of treatment
100%
$50
1.0
diagnostic a
60%
$50
6.0
medication b: completes course
40%
$50
3.0
medication b: completes half course
Pulmonary TB
inpatient
100%
$6,000
1.0
hospitalization
100%
$100
3.0
physician b
100%
$50
1.0
diagnostic a
25%
$500
1.0
diagnostic c
Pulmonary TB
outpatient
100%
$50
9.0
physician a
100%
$50
9.0
diagnostic a
100%
$50
9.0
medication b
Extrapulmonary TB
inpatient
100%
$6,000
1.0
hospitalization
100%
$100
3.0
physician b
100%
$50
1.0
diagnostic b
25%
$500
1.0
diagnostic c
Extrapulmonary TB
outpatient
100%
$50
9.0
physician a
100%
$50
9.0
diagnostic a
100%
$50
9.0
medication b
If a vaccine program for TB were implemented today and the vaccine was 100% efficacious and utilized by 100% of the target population, the annualized present value of the health care costs saved would be $100 million. Using committee assumptions of less-than-ideal efficacy and utilization and including time
