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. 2023 Mar;130(4):396-406.
doi: 10.1111/1471-0528.17348. Epub 2022 Dec 19.

Saliva microRNA signature to diagnose endometriosis: A cost-effectiveness evaluation of the Endotest®

Clement Ferrier  1   2 , Sofiane Bendifallah  1   2 , Stéphane Suisse  3 , Yohann Dabi  1   2 , Cyril Touboul  1   2 , Anne Puchar  1   2 , Kevin Zarca  4   5 , Isabelle Durand Zaleski  4   5
Affiliations

Saliva microRNA signature to diagnose endometriosis: A cost-effectiveness evaluation of the Endotest®

Clement Ferrier et al. BJOG. 2023 Mar.

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.

Keywords: cost-effectiveness analysis; diagnosis; endometriosis; health economics; saliva miRNA signature.

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References

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