Ferrier C, Bendifallah S, Suisse S, Dabi Y, Touboul C, Puchar A, Zarca K, Durand Zaleski I. Saliva microRNA signature to diagnose endometriosis: A cost-effectiveness evaluation of the Endotest®.
BJOG 2023;
130:396-406. [PMID:
36424910 DOI:
10.1111/1471-0528.17348]
[Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 11/03/2022] [Accepted: 11/05/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE
To evaluate a saliva diagnostic test (Endotest®) for endometriosis compared with the conventional algorithm.
DESIGN
A cost-effectiveness analysis with a decision-tree model based on literature data.
SETTING
France.
POPULATION
Women with chronic pelvic pain.
METHODS
Strategy I is the French algorithm, representing the comparator. For strategy II, all patients have an Endotest®. For strategy III, patients undergo ultrasonography to detect endometrioma and patients with no endometrioma detected have an Endotest®. For strategy IV, patients with no endometrioma detected on ultrasonography undergo pelvic magnetic resonance imaging (MRI) to detect endometrioma and/or deep endometriosis. An Endotest® is then performed for patients with a negative result on MRI.
MAIN OUTCOMES MEASURES
Costs and accuracy rates and incremental cost-effectiveness ratios (ICERs). Three analyses were performed with an Endotest® priced at €500, €750, and €1000. Probabilistic sensitivity analysis was conducted with Monte Carlo simulations.
RESULTS
With an Endotest® priced at €750, the cost per correctly diagnosed case was €1542, €990, €919 and €1000, respectively, for strategies I, II, III and IV. Strategy I was dominated by all other strategies. Strategies IV, III and II were, respectively, preferred for a willingness-to-pay threshold below €473, between €473 and €4670, and beyond €4670 per correctly diagnosed case. At a price of €500 per Endotest®, strategy I was dominated by all other strategies. At €1000, the ICERs of strategies II and III were €724 and €387 per correctly diagnosed case, respectively, compared with strategy I.
CONCLUSION
The present study demonstrates the value of the Endotest® from an economic perspective.
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