Modelling the impact of rapid diagnostic tests on Plasmodium vivax malaria in South Korea: a cost–benefit analysis
Background Rapid diagnostic tests (RDTs) are widely used for diagnosing Plasmodium vivax malaria, especially in resource-limited countries. However, the impact of RDTs on P. vivax malaria incidence and national medical costs has not been evaluated. We assessed the impact of RDT implementation on P....
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doaj-1455fd12af504226918fd00ba26c22242021-03-25T19:30:18ZengBMJ Publishing GroupBMJ Global Health2059-79082021-02-016210.1136/bmjgh-2020-004292Modelling the impact of rapid diagnostic tests on Plasmodium vivax malaria in South Korea: a cost–benefit analysisJun Yong Choi0Jung Ho Kim1Jiyeon Suh2Woon Ji Lee3Heun Choi4Jong-Dae Kim5Changsoo Kim6Ryeojin Ko7Heewon Kim8Jeehyun Lee9Joon Sup Yeom10Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, South Korea 1 Department of Emergency Medicine, Yeungnam University School of Medicine and College of Medicine, Daegu, Korea School of Mathematics and Computing (Computational Science and Engineering), Yonsei University, Seoul, South KoreaDepartment of Internal Medicine, AIDS Research Institute, Yonsei University College of Medicine, Seoul, South KoreaDepartment of Internal Medicine, National Health Insurance Service Ilsan hospital, Goyang, South KoreaDepartment of General Surgery, Bestian Woosong Hospital, Daejeon, South KoreaDepartment of Preventive Medicine, Yonsei University College of Medicine, Seoul, South KoreaDepartment of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, South KoreaDepartment of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, South KoreaSchool of Mathematics and Computing, Yonsei University, Seoul, South KoreaDepartment of Internal Medicine, AIDS Research Institute, Yonsei University College of Medicine, Seoul, South KoreaBackground Rapid diagnostic tests (RDTs) are widely used for diagnosing Plasmodium vivax malaria, especially in resource-limited countries. However, the impact of RDTs on P. vivax malaria incidence and national medical costs has not been evaluated. We assessed the impact of RDT implementation on P. vivax malaria incidence and overall medical expenditures in South Korea and performed a cost–benefit analysis from the payer’s perspective.Methods We developed a dynamic compartmental model for P. vivax malaria transmission in South Korea using delay differential equations. Long latency and seasonality were incorporated into the model, which was calibrated to civilian malaria incidences during 2014–2018. We then estimated averted malaria cases and total medical costs from two diagnostic scenarios: microscopy only and both microscopy and RDTs. Medical costs were extracted based on data from a hospital in an at-risk area for P. vivax malaria and were validated using Health Insurance Review and Assessment Service data. We conducted a cost–benefit analysis of RDTs using the incremental benefit:cost ratio (IBCR) considering only medical costs and performed a probabilistic sensitivity analysis to reflect the uncertainties of model parameters, costs and benefits.Results The results showed that 55.3% of new P. vivax malaria cases were averted, and $696 214 in medical costs was saved over 10 years after RDT introduction. The estimated IBCR was 2.5, indicating that RDT implementation was beneficial, compared with microscopy alone. The IBCR was sensitive to the diagnosis time reduction, infectious period and short latency period, and provided beneficial results in a benefit over $10.6 or RDT cost under $39.7.Conclusions The model simulation suggested that RDTs could significantly reduce P. vivax malaria incidence and medical costs. Moreover, cost–benefit analysis demonstrated that the introduction of RDTs was beneficial over microscopy alone. These results support the need for widespread adoption of RDTs.https://gh.bmj.com/content/6/2/e004292.full |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jun Yong Choi Jung Ho Kim Jiyeon Suh Woon Ji Lee Heun Choi Jong-Dae Kim Changsoo Kim Ryeojin Ko Heewon Kim Jeehyun Lee Joon Sup Yeom |
spellingShingle |
Jun Yong Choi Jung Ho Kim Jiyeon Suh Woon Ji Lee Heun Choi Jong-Dae Kim Changsoo Kim Ryeojin Ko Heewon Kim Jeehyun Lee Joon Sup Yeom Modelling the impact of rapid diagnostic tests on Plasmodium vivax malaria in South Korea: a cost–benefit analysis BMJ Global Health |
author_facet |
Jun Yong Choi Jung Ho Kim Jiyeon Suh Woon Ji Lee Heun Choi Jong-Dae Kim Changsoo Kim Ryeojin Ko Heewon Kim Jeehyun Lee Joon Sup Yeom |
author_sort |
Jun Yong Choi |
title |
Modelling the impact of rapid diagnostic tests on Plasmodium vivax malaria in South Korea: a cost–benefit analysis |
title_short |
Modelling the impact of rapid diagnostic tests on Plasmodium vivax malaria in South Korea: a cost–benefit analysis |
title_full |
Modelling the impact of rapid diagnostic tests on Plasmodium vivax malaria in South Korea: a cost–benefit analysis |
title_fullStr |
Modelling the impact of rapid diagnostic tests on Plasmodium vivax malaria in South Korea: a cost–benefit analysis |
title_full_unstemmed |
Modelling the impact of rapid diagnostic tests on Plasmodium vivax malaria in South Korea: a cost–benefit analysis |
title_sort |
modelling the impact of rapid diagnostic tests on plasmodium vivax malaria in south korea: a cost–benefit analysis |
publisher |
BMJ Publishing Group |
series |
BMJ Global Health |
issn |
2059-7908 |
publishDate |
2021-02-01 |
description |
Background Rapid diagnostic tests (RDTs) are widely used for diagnosing Plasmodium vivax malaria, especially in resource-limited countries. However, the impact of RDTs on P. vivax malaria incidence and national medical costs has not been evaluated. We assessed the impact of RDT implementation on P. vivax malaria incidence and overall medical expenditures in South Korea and performed a cost–benefit analysis from the payer’s perspective.Methods We developed a dynamic compartmental model for P. vivax malaria transmission in South Korea using delay differential equations. Long latency and seasonality were incorporated into the model, which was calibrated to civilian malaria incidences during 2014–2018. We then estimated averted malaria cases and total medical costs from two diagnostic scenarios: microscopy only and both microscopy and RDTs. Medical costs were extracted based on data from a hospital in an at-risk area for P. vivax malaria and were validated using Health Insurance Review and Assessment Service data. We conducted a cost–benefit analysis of RDTs using the incremental benefit:cost ratio (IBCR) considering only medical costs and performed a probabilistic sensitivity analysis to reflect the uncertainties of model parameters, costs and benefits.Results The results showed that 55.3% of new P. vivax malaria cases were averted, and $696 214 in medical costs was saved over 10 years after RDT introduction. The estimated IBCR was 2.5, indicating that RDT implementation was beneficial, compared with microscopy alone. The IBCR was sensitive to the diagnosis time reduction, infectious period and short latency period, and provided beneficial results in a benefit over $10.6 or RDT cost under $39.7.Conclusions The model simulation suggested that RDTs could significantly reduce P. vivax malaria incidence and medical costs. Moreover, cost–benefit analysis demonstrated that the introduction of RDTs was beneficial over microscopy alone. These results support the need for widespread adoption of RDTs. |
url |
https://gh.bmj.com/content/6/2/e004292.full |
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