Cost-effectiveness of AQP4 antibody detection with cell-based assay compared with elisa for devic disease diagnosis in Colombia

View/ Open
Date
2015-05-01Corporate Author(s)
Pontificia Universidad Javeriana. Facultad de Medicina. Departamento de Medicina Interna. Enfermedades Crónicas del Adulto
Type
Artículo de revista
ISSN
1524-4733 / 1098-3015 (Electrónico)
Pages
A44
Share this record
Citación
Metadata
Show full item record
PDF documents
Abstract
Objectives
Neuromyelitis optica (NMO) or Devic disease is a rare chronic condition characterized by demyelinating lesions in the central nervous system. The aim of this study was to evaluate cost-effectiveness of the detection of antibodies against the protein aquaporin water channel 4 (AQP4) with cell-based assay (CBA), compared with ELISA, for the diagnosis of NMO in Colombia.
Methods
A decision tree model was constructed to compare costs, correctly diagnosed cases and relapses averted in patients with clinical suspicion of NMO, that were subjected to diagnostic tests for the detection of AQP4 antibodies. The analysis was undertaken from a third-party payer perspective, one year time horizon (first year with the disease) taking all costs for treatment and relapses, in 2014 Colombian pesos, from official published prices (1 USD = 2,033 COP). Since the CBA kit is not available in Colombia (currently samples are processed abroad), the price was obtained from the manufacturer and set in a national laboratory. Clinical variables were from a systematic literature review. Univariate and probabilistic sensitivity analyses (a Monte Carlo simulating a cohort of 1000 patients) were conducted.
Results
Identification of AQP4 antibodies with CBA is a dominant strategy: more effective (855 correctly diagnosed patients compared with 765 detected by ELISA, and 130 avoided relapses), and less costly, with expected yearly costs per correctly diagnosed Devic patient of USD $14,658 compared with $15,614 for ELISA. Using CBA may represent savings in terms of reduced costs of treating disease and relapse with hospitalization.
Conclusions
AQP4 antibody identification by the CBA method is a cost-saving diagnostic test, dominant over the ELISA method.
Spatial coverage
ColombiaLink to the resource
https://www.valueinhealthjournal.com/article/S1098-3015(15)00316-2/fulltext?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS1098301515003162%3Fshowall%3Dtrue#%20Source
Value in Health; Vol. 18 Núm. 3 (2015)
Google Analytics Statistics
Collections
- Artículos [275]