it aint so easy, page-6

roboshan, your words ring true:-

"once the automated "in tube" systems become common place over the next few years the comparative cost of conducting the skin test will be the prohibitive factor. Remember it is labour costs not the cost of each test that is the biggest overhead for agencies."

This seems to be where the problem lies, even the second gen QFTG test was cost competitive if you took all factors into account. But particularly in the public sector there is a huge divide between the operational people and the beancounters. All the beancounters tend to look at is the TST test cost say $6 and QFTG costs say $20. End of story, they sign the cheques thus TST it is.
Virtually no consideration of staff time either administering and reading a TST and the lost working time of the person being tested let alone the cost of false diagnosis.
I realise that the beancounters are slowly being dragged into the 21st century in a number of cities and states throughout the world but heck it is a long hard road and undoubtedly one of the main reasons for the slower than expected takeup.
There have been a number of important independent costing studies published over the past year or so and undoubtedly they are now helping change attitudes.

In many places the penny has dropped, take SF public health for instance they place much emphasis on overall cost and thus are now using QFTG but still the large majority of public health organisations throughout the world are using TST.

Maybe if we are lucky enough, particularly when IT finally gets FDA approval, there will be stronger statements made by the FDA or the CDC as to the desirability cost wise for a concerted effort by the public sector to improve efficiencies and save health $s by changing over.
At this stage the private sector is certainly leading the way.