Background:Tuberculosis continues to be a significant global burden. Purified protein derivative of tuberculin (TB-PPD) is one type of tuberculin skin test (TST) and is used commonly for the auxiliary diagnosis of tuberculosis. The recombinantMycobacterium tuberculosisfusion protein (EC) test is a new test developed in China.Objective:Evaluate the long-term economic implications of using the EC test compared with the TB-PPD test to provide a reference for clinical decision-making.Methods:The target population was people at a high risk persons of being infected withMycobacterium tuberculosis. The outcome indicator was quality-adjusted life years (QALY). A cost–utility analysis was used to evaluate the long-term economic implications of using the EC test compared with the TB-PPD test. We employed a decision tree–Markov model from the perspective of the whole society within 77 years.Results:Compared with the TB-PPD test, the EC test had a lower cost but higher QALY. The incremental cost–utility ratio was −119,800.7381 CNY/QALY. That is, for each additional QALY, the EC test could save 119,800.7381 CNY: the EC test was more economical than the TB-PPD test.Conclusion:Compared with the TB-PPD test, the EC test would be more economical in the long term for the diagnosis ofM. tuberculosisinfection according our study.