Scenario | Baseline | 1 Short time to treat | 2 Low prevalence | 3 No PID or onward transmission | 4 High POC NAAT test cost | 5 Wait for test anxiety |
---|---|---|---|---|---|---|
See tables 1 and 2 for full baseline parameter list | Rx time=4 days (baseline: 10 days) | CT=4.3% M, 3.7% F NG=1.3% M, 0.5% F (baseline: CT=8.6% M, 7.4% F, NG=2.5% M, 0.9% F) | Transmission probability 0% for CT/NG, PID=0 (baseline: 5% CT, 10% NG per unprotected act, PID=0.00035 per day) | POC NAAT test cost=£29.73 (baseline £19.73) | Utility post-test status unknown=0.95 (baseline: 1) | |
SC | ||||||
Cost | £115 627 887 | £115 613 353 | £112 997 661 | £115 595 915 | £115 627 887 | £115 627 887 |
QALY | 184 012 | 184 013 | 184 036 | 184 015 | 184 012 | 181 523 |
Transmissions | 17 561 | 7434 | 8811 | – | 17 561 | 17 561 |
PID | 223 | 132 | 119 | – | 223 | 223 |
Overtreatment | 95 382 | 95 382 | 100 278 | 95 431 | 95 382 | 95 382 |
POC | ||||||
Cost | £103 873 872 | £103 873 872 | £101 452 506 | £103 868 307 | £116 078 901 | £103 873 872 |
QALY | 184 059 | 184 059 | 184 084 | 184 059 | 184 059 | 184 059 |
Transmissions | – | – | – | – | – | – |
PID | 34 | 34 | 17 | – | 34 | 34 |
Overtreatment | – | – | – | – | – | – |
Difference (POC-SC) | ||||||
Cost | −£11 754 015 | −£11 739 481 | −£11 545 155 | −£11 727 608 | £451 014 | −£11 754 015 |
QALY | 46 | 45 | 48 | 44 | 46 | 2536 |
Transmissions | −17 561 | −7434 | −8811 | 0 | −17 561 | −17 561 |
PID | −189 | −98 | −102 | 0 | −189 | −189 |
Overtreatment | −95 382 | −95 382 | −100 278 | −95 431 | −95 382 | −95 382 |
CT, Chlamydia trachomatis, NAAT, nucleic acid amplification test; NG, Neisseria gonorrhoea, PID, pelvic inflammatory disease, POC, point of care; QALY, quality adjusted life year; Rx, treatment; SC, standard care.