Outcomes for a prison of 1,000 individuals in Tajikistan, the Russian Federation, and Latvia.

All costs are given in 2009 US dollars. Quality of life weights used for these analyses are shown in Table S8. Shown are TB and MDR-TB prevalence rates, total costs, and total QALYs saved at the end of 10 y as well as ICERs for all eight strategies in three specific countries. Initial TB prevalence rates for Tajikistan, Russian Federation, and Latvia were 3.55%, 2.74%, and 1.25%, respectively. Initial MDR-TB prevalence rates were 0.92%, 0.75%, and 0.32%, respectively.aIn the table, the term “incremental” refers to comparison between non-dominated strategies and their next best alternative. In the cases of Tajikistan and Russia, sputum PCR screening is compared to combined MMR and symptom screening and MMR screening with sputum PCR detection of MDR-TB, respectively. In the case of Latvia, multiple strategies are non-dominated and hence are each compared to their next best alternative (i.e., the immediately preceding strategy in the table). Dominated strategies cost more and provide less health benefit than an alternative strategy.bIn each country, the marked strategy costs less and is more effective than MMR screening, the current status quo in prisons in the FSU. Hence, it dominates the current status quo and is then the reference strategy for the analysis.cCombined MMR and symptom screening is dominated via extended dominance—i.e., its ratio of additional costs (US$88,763) to additional QALYs (49) compared to MMR screening with sputum PCR detection of MDR-TB is less favorable than for sputum PCR screening (US$1,811/QALY versus US$1,569/QALY). Therefore, if the decision maker is prepared to pay this less favorable, higher amount for additional QALYs from combined MMR and symptom screening, he or she should be prepared to implement sputum PCR screening, since it provides better value for money.