Early economic evaluation to identify the necessary test characteristics of a new typhoid test to be cost-effective in Ghana

Research output: Contribution to journalArticle

Standard

Harvard

APA

Vancouver

Author

Bibtex

@article{2e00b8ef1b414e3093d3e849b834690c,
title = "Early economic evaluation to identify the necessary test characteristics of a new typhoid test to be cost-effective in Ghana",
abstract = "Background: In Ghana, there are issues with the diagnosis of typhoid fever, these include: delays in diagnosis; concerns about the accuracy of current tests; and lack of availability. These issues highlight the need for the development of a rapid, accurate, and easily accessible diagnostic test. The aim of this study was to conduct an early economic analysis of a hypothetical rapid test for typhoid fever diagnosis in Ghana and identify the necessary characteristics of the test for it to be cost-effective in Ghana. Methods: An early cost-utility analysis was conducted using a decision tree parameterized with secondary data sources, with reasonable assumptions made for unknown parameters. The patient population considered is individuals presenting with symptoms suggestive of typhoid fever at a healthcare facility in Ghana, a time horizon of 180 days and the Ghanaian national health service perspective were adopted for the analysis. Extensive sensitivity analysis was undertaken including headroom analysis. Results: The results here show that for a hypothetical test to perform better than the existing test (Widal) in terms of QALYs gained and cost-effectiveness, it is necessary for it to have a high specificity (at least 70%) and should not be priced more than $4. The overall value of conducting research to reduce uncertainty (over 5yrs) is $3,287.Conclusion: The analysis shows the potential for the hypothetical test to replace the Widal test and the market potential of developing a new test in the Ghanaian setting.Key Points for Decision makers•This study has wider implications for the early economic evaluation of diagnostic tests by contributing to a limited evidence base and identifying areas requiring further research. •A high specificity (at least 70%) is a key test characteristic requirement for the hypothetical test (HT-test) to be able to improve current practice, and the HT-test is likely to improve current practice when used to replace the currently used test rather than use as triage or add-on.",
keywords = "early economic evaluation, diagnostic test, headroom analysis, value of information analysis, typhoid fever, Ghana",
author = "Samuel Frempong and Andrew Sutton and Clare Davenport and Pelham Barton",
year = "2019",
month = aug,
day = "3",
doi = "10.1007/s41669-019-0159-7",
language = "English",
journal = "PharmacoEconomics",
issn = "1170-7690",
publisher = "Springer",

}

RIS

TY - JOUR

T1 - Early economic evaluation to identify the necessary test characteristics of a new typhoid test to be cost-effective in Ghana

AU - Frempong, Samuel

AU - Sutton, Andrew

AU - Davenport, Clare

AU - Barton, Pelham

PY - 2019/8/3

Y1 - 2019/8/3

N2 - Background: In Ghana, there are issues with the diagnosis of typhoid fever, these include: delays in diagnosis; concerns about the accuracy of current tests; and lack of availability. These issues highlight the need for the development of a rapid, accurate, and easily accessible diagnostic test. The aim of this study was to conduct an early economic analysis of a hypothetical rapid test for typhoid fever diagnosis in Ghana and identify the necessary characteristics of the test for it to be cost-effective in Ghana. Methods: An early cost-utility analysis was conducted using a decision tree parameterized with secondary data sources, with reasonable assumptions made for unknown parameters. The patient population considered is individuals presenting with symptoms suggestive of typhoid fever at a healthcare facility in Ghana, a time horizon of 180 days and the Ghanaian national health service perspective were adopted for the analysis. Extensive sensitivity analysis was undertaken including headroom analysis. Results: The results here show that for a hypothetical test to perform better than the existing test (Widal) in terms of QALYs gained and cost-effectiveness, it is necessary for it to have a high specificity (at least 70%) and should not be priced more than $4. The overall value of conducting research to reduce uncertainty (over 5yrs) is $3,287.Conclusion: The analysis shows the potential for the hypothetical test to replace the Widal test and the market potential of developing a new test in the Ghanaian setting.Key Points for Decision makers•This study has wider implications for the early economic evaluation of diagnostic tests by contributing to a limited evidence base and identifying areas requiring further research. •A high specificity (at least 70%) is a key test characteristic requirement for the hypothetical test (HT-test) to be able to improve current practice, and the HT-test is likely to improve current practice when used to replace the currently used test rather than use as triage or add-on.

AB - Background: In Ghana, there are issues with the diagnosis of typhoid fever, these include: delays in diagnosis; concerns about the accuracy of current tests; and lack of availability. These issues highlight the need for the development of a rapid, accurate, and easily accessible diagnostic test. The aim of this study was to conduct an early economic analysis of a hypothetical rapid test for typhoid fever diagnosis in Ghana and identify the necessary characteristics of the test for it to be cost-effective in Ghana. Methods: An early cost-utility analysis was conducted using a decision tree parameterized with secondary data sources, with reasonable assumptions made for unknown parameters. The patient population considered is individuals presenting with symptoms suggestive of typhoid fever at a healthcare facility in Ghana, a time horizon of 180 days and the Ghanaian national health service perspective were adopted for the analysis. Extensive sensitivity analysis was undertaken including headroom analysis. Results: The results here show that for a hypothetical test to perform better than the existing test (Widal) in terms of QALYs gained and cost-effectiveness, it is necessary for it to have a high specificity (at least 70%) and should not be priced more than $4. The overall value of conducting research to reduce uncertainty (over 5yrs) is $3,287.Conclusion: The analysis shows the potential for the hypothetical test to replace the Widal test and the market potential of developing a new test in the Ghanaian setting.Key Points for Decision makers•This study has wider implications for the early economic evaluation of diagnostic tests by contributing to a limited evidence base and identifying areas requiring further research. •A high specificity (at least 70%) is a key test characteristic requirement for the hypothetical test (HT-test) to be able to improve current practice, and the HT-test is likely to improve current practice when used to replace the currently used test rather than use as triage or add-on.

KW - early economic evaluation

KW - diagnostic test

KW - headroom analysis

KW - value of information analysis

KW - typhoid fever

KW - Ghana

U2 - 10.1007/s41669-019-0159-7

DO - 10.1007/s41669-019-0159-7

M3 - Article

C2 - 31377968

JO - PharmacoEconomics

JF - PharmacoEconomics

SN - 1170-7690

ER -