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Early Economic Evaluation to Identify the Necessary Test Characteristics of a New Typhoid Test to be Cost Effective in Ghana

Author

Listed:
  • Samuel N. Frempong

    (University of Birmingham)

  • Andrew J. Sutton

    (Institute of Health Economics)

  • Clare Davenport

    (University of Birmingham)

  • Pelham Barton

    (University of Birmingham)

Abstract

Background In Ghana, there are issues with the diagnosis of typhoid fever; these include delays in diagnosis, concerns about the accuracy of current tests, and lack of availability. These issues highlight the need for the development of a rapid, accurate, and easily accessible diagnostic test. The aim of this study was to conduct an early economic analysis of a hypothetical rapid test for typhoid fever diagnosis in Ghana and identify the necessary characteristics of the test for it to be cost effective in Ghana. Methods An early cost-utility analysis was conducted using a decision tree parameterized with secondary data sources, with reasonable assumptions made for unknown parameters. The patient population considered is individuals presenting with symptoms suggestive of typhoid fever at a healthcare facility in Ghana; a time horizon of 180 days and the Ghanaian national health service perspective were adopted for the analysis. Extensive sensitivity analysis was undertaken, including headroom analysis. Results The results here show that for a hypothetical test to perform better than the existing test (Widal) in terms of QALYs gained and cost effectiveness, it is necessary for it to have a high specificity (at least 70%) and should not be priced more than US$4. The overall value of conducting research to reduce uncertainty (over 5 years) is US$3287. Conclusion The analysis shows the potential for the hypothetical test to replace the Widal test and the market potential of developing a new test in the Ghanaian setting.

Suggested Citation

  • Samuel N. Frempong & Andrew J. Sutton & Clare Davenport & Pelham Barton, 2020. "Early Economic Evaluation to Identify the Necessary Test Characteristics of a New Typhoid Test to be Cost Effective in Ghana," PharmacoEconomics - Open, Springer, vol. 4(1), pages 143-157, March.
    • Handle: RePEc:spr:pharmo:v:4:y:2020:i:1:d:10.1007_s41669-019-0159-7
    DOI: 10.1007/s41669-019-0159-7
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    References listed on IDEAS

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    1. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
    2. Roger M. Harbord & Penny Whiting, 2009. "metandi: Meta-analysis of diagnostic accuracy using hierarchical logistic regression," Stata Journal, StataCorp LP, vol. 9(2), pages 211-229, June.
    3. Beth Woods & Paul Revill & Mark Sculpher & Karl Claxton, 2015. "Country-level cost-effectiveness thresholds: initial estimates and the need for further research," Working Papers 109cherp, Centre for Health Economics, University of York.
    4. Samuel N. Frempong & Clare Davenport & Andrew J. Sutton & Justice Nonvignon & Pelham Barton, 2018. "Integrating Qualitative Techniques in Model Development: A Case Study Using the Framework Approach," Applied Health Economics and Health Policy, Springer, vol. 16(5), pages 723-733, October.
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