Quest Diagnostics, San Juan, Capistrano, CA, United States.
Quest Diagnostics, San Juan, Capistrano, CA, United States.
Diagn Microbiol Infect Dis. 2020 Oct;98(2):115119. doi: 10.1016/j.diagmicrobio.2020.115119. Epub 2020 Jun 25.
We evaluated the cost-effectiveness of test-and-treat scenarios for vaginitis, scenarios based on clinical and microscopic examination (CME), nucleic acid amplification testing (NAAT), or nonamplified nucleic acid probe (probe) testing. The symptom resolution outcome and the payer cost of diagnosis and treatment were estimated in decision analytical models in a hypothetical patient population. Compared with probe testing, NAAT resulted in symptom resolution in more patients (615 versus 475 per 1000 tested) at a cost of $210 per incremental symptom resolution, a cost lower than the willingness to pay for symptom resolution ($871) implied by payer coverage for probe testing. Following a negative CME, the NAAT scenario resulted in symptom resolution in more patients (650 per 1000 patients tested) than did either CME (525) or the CME probe testing-based scenario (602) at incremental cost-effectiveness ratios lower than the willingness to pay implied by coverage for CME. Therefore, NAAT is likely to cost-effectively improve health outcomes for patients with vaginitis.
我们评估了阴道炎的检测和治疗方案的成本效益，这些方案基于临床和显微镜检查（CME）、核酸扩增检测（NAAT）或非扩增核酸探针（探针）检测。在假设的患者人群中，通过决策分析模型估计症状缓解结局和支付者的诊断和治疗成本。与探针检测相比，NAAT 在更多患者中实现了症状缓解（每 1000 人检测中增加了 615 人，而不是 475 人），每增加一个症状缓解的成本为 210 美元，低于探针检测支付者覆盖范围所隐含的症状缓解意愿支付额（871 美元）。在 CME 检测呈阴性后，NAAT 方案在更多患者中实现了症状缓解（每 1000 名患者检测中增加了 650 名，而不是 CME 方案的 525 名或基于 CME 探针检测的方案的 602 名），增量成本效益比低于 CME 覆盖范围所隐含的意愿支付额。因此，NAAT 可能会有效地改善阴道炎患者的健康结局。
