Student Research Committee, Urmia University of Medical Sciences, Urmia, Iran.
Health Education Department, Urmia University of Medical Sciences, Health deputy, Urmia, Iran.
BMC Health Serv Res. 2023 Aug 14;23(1):861. doi: 10.1186/s12913-023-09868-9.
Since 2020, COVID-19 has become a global public health issue and has caused problems worldwide. This infection can lead to a fever and respiratory problems. Asymptomatic carriers of the virus are a significant part of the spread of the disease, so early screening and diagnosis of suspected cases of COVID-19 are essential. Generally, standard diagnostic methods include lung imaging (CT), polymerase chain reaction (PCR), and corona antibody (IgM&IgG) testing. However, the costs of the above tests for the healthcare system cannot be ignored, and evaluating the incremental costs against the additional benefit is necessary. Therefore, this study aimed to determine the cost-effectiveness of diagnostic methods for COVID-19 patients.
In this research, an economic evaluation analysis was conducted to reveal the cost-effectiveness of the diagnostic strategies for COVID-19 from the service provider's perspective. Basic information about the costs of CT, serology (IgG&IgM), and molecular (PCR) tests were collected from the Ministry of Health of Iran. The effectiveness data were calculated according to the sensitivity and specificity of the diagnostic tests for COVID-19. In this study, the incremental cost-effectiveness ratio (ICER) of the diagnostic strategies for COVID-19 was estimated, and the most cost-effective diagnostic strategy was determined. In calculating ICER and analyzing the sensitivity of the results, Treeage software was used.
According to the calculated incremental effectiveness cost ratio for scenarios with 5, 10, and 50% prevalence of COVID-19 and according to the threshold defined by the World Health Organization, in the study, PCR, PCR, and IgG&IgM strategies are the most cost-effective diagnostic methods of the corona. Also, the results were not sensitive to the desired parameters based on the results of one-way sensitivity analysis.
Nowadays there are various tests with different levels of accuracy in the diagnosis of COVID-19. In general, PCR tests are more cost-effective for low prevalence of Covid-19, while IgM&IgG tests are more cost-effective for high estimated prevalence. The results of this research can help policymakers and health system managers to validate the most accurate diagnostic method for COVID-19, considering the prevalence of the disease.
自 2020 年以来，COVID-19 已成为全球性公共卫生问题，并在全球范围内造成了问题。这种感染会导致发烧和呼吸道问题。病毒的无症状携带者是疾病传播的重要组成部分，因此对 COVID-19 疑似病例进行早期筛查和诊断至关重要。通常，标准诊断方法包括肺部成像（CT）、聚合酶链反应（PCR）和冠状病毒抗体（IgM 和 IgG）检测。然而，上述测试对医疗保健系统的成本不容忽视，评估增量成本与额外收益是必要的。因此，本研究旨在确定 COVID-19 患者诊断方法的成本效益。
在这项研究中，从服务提供者的角度进行了经济评估分析，以揭示 COVID-19 诊断策略的成本效益。从伊朗卫生部收集了有关 CT、血清学（IgG 和 IgM）和分子（PCR）测试成本的基本信息。根据 COVID-19 诊断测试的灵敏度和特异性计算有效性数据。在本研究中，估计了 COVID-19 诊断策略的增量成本效益比（ICER），并确定了最具成本效益的诊断策略。在计算 ICER 和分析结果的敏感性时，使用了 Treeage 软件。
根据 COVID-19 患病率为 5%、10%和 50%的情况下计算的增量有效性成本比，以及世界卫生组织定义的阈值，在本研究中，PCR、PCR 和 IgG&IgM 策略是最具成本效益的 COVID-19 诊断方法。此外，根据单向敏感性分析的结果，结果对所需参数不敏感。
目前，COVID-19 的诊断有各种准确性不同的测试。一般来说，对于 COVID-19 低流行率，PCR 测试更具成本效益，而对于高估计流行率，IgM&IgG 测试更具成本效益。本研究的结果可以帮助政策制定者和卫生系统管理者在考虑疾病流行率的情况下验证 COVID-19 的最准确诊断方法。
