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Cost-effectiveness of testing for Mycoplasma genitalium among men who have sex with men in Australia.
Ong, Jason J; Lim, Aaron; Bradshaw, Catriona; Taylor-Robinson, David; Unemo, Magnus; Horner, Paddy J; Vickerman, Peter; Zhang, Lei.
Afiliação
  • Ong JJ; Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia jason.ong@monash.edu.
  • Lim A; London School of Hygiene and Tropical Medicine, London, UK.
  • Bradshaw C; Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.
  • Taylor-Robinson D; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
  • Unemo M; Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia.
  • Horner PJ; Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.
  • Vickerman P; Faculty of Medicine, Imperial College London, London, UK.
  • Zhang L; WHO Collaborating Centre for Gonorrhoea and Other STIs, Örebro University, Orebro, Sweden.
Sex Transm Infect ; 99(6): 398-403, 2023 Aug 17.
Article em En | MEDLINE | ID: mdl-36958826
ABSTRACT

OBJECTIVES:

Mycoplasma genitalium (MG) disproportionately affects men who have sex with men (MSM). We determined the cost-effectiveness of different testing strategies for MG in MSM, taking a healthcare provider perspective.

METHODS:

We used inputs from a dynamic transmission model of MG among MSM living in Australia in a decision tree model to evaluate the impact of four testing scenarios on MG incidence (1) no one tested; (2) symptomatic MSM; (3) symptomatic and high-risk asymptomatic MSM; (4) all MSM. We calculated the incremental cost-effectiveness ratios (ICERs) using a willingness-to-pay threshold of $A30 000 per quality-adjusted life year (QALY) gained. We explored the impact of adding an antimicrobial resistance (AMR) tax (ie, additional cost per antibiotic consumed) to identify the threshold, whereby any testing for MG is no longer cost-effective.

RESULTS:

Testing only symptomatic MSM is the most cost-effective (ICER $3677 per QALY gained) approach. Offering testing to all MSM is dominated (ie, higher costs and lower QALYs gained compared with other strategies). When the AMR tax per antibiotic given was above $150, any testing for MG was no longer cost-effective.

CONCLUSION:

Testing only symptomatic MSM is the most cost-effective option, even when the potential costs associated with AMR are accounted for (up to $150 additional cost per antibiotic given). For pathogens like MG, where there are anticipated future costs related to AMR, we recommend models that test the impact of incorporating an AMR tax as they can change the results and conclusions of cost-effectiveness studies.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Health_economic_evaluation / Prognostic_studies Limite: Humans / Male Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Health_economic_evaluation / Prognostic_studies Limite: Humans / Male Idioma: En Ano de publicação: 2023 Tipo de documento: Article