RT Journal Article SR Electronic T1 Cost-effectiveness of testing for Mycoplasma genitalium among men who have sex with men in Australia JF Sexually Transmitted Infections JO Sex Transm Infect FD BMJ Publishing Group Ltd SP 398 OP 403 DO 10.1136/sextrans-2022-055611 VO 99 IS 6 A1 Jason J Ong A1 Aaron Lim A1 Catriona Bradshaw A1 David Taylor-Robinson A1 Magnus Unemo A1 Paddy J Horner A1 Peter Vickerman A1 Lei Zhang YR 2023 UL http://sti.bmj.com/content/99/6/398.abstract AB Objectives Mycoplasma genitalium (MG) disproportionately affects men who have sex with men (MSM). We determined the cost-effectiveness of different testing strategies for MG in MSM, taking a healthcare provider perspective.Methods We used inputs from a dynamic transmission model of MG among MSM living in Australia in a decision tree model to evaluate the impact of four testing scenarios on MG incidence: (1) no one tested; (2) symptomatic MSM; (3) symptomatic and high-risk asymptomatic MSM; (4) all MSM. We calculated the incremental cost-effectiveness ratios (ICERs) using a willingness-to-pay threshold of $A30 000 per quality-adjusted life year (QALY) gained. We explored the impact of adding an antimicrobial resistance (AMR) tax (ie, additional cost per antibiotic consumed) to identify the threshold, whereby any testing for MG is no longer cost-effective.Results Testing only symptomatic MSM is the most cost-effective (ICER $3677 per QALY gained) approach. Offering testing to all MSM is dominated (ie, higher costs and lower QALYs gained compared with other strategies). When the AMR tax per antibiotic given was above $150, any testing for MG was no longer cost-effective.Conclusion Testing only symptomatic MSM is the most cost-effective option, even when the potential costs associated with AMR are accounted for (up to $150 additional cost per antibiotic given). For pathogens like MG, where there are anticipated future costs related to AMR, we recommend models that test the impact of incorporating an AMR tax as they can change the results and conclusions of cost-effectiveness studies.Data are available upon reasonable request.