Thermo Fisher Scientific, Sweden
Keynote: Prim Health Care
The majority of bowel disorders exhibit overlapping symptoms, making diagnosis difficult in primary care (PC). Inflammatory bowel diseases (IBDs) are characterized by chronic inflammation of the gastrointestinal tract; irritable bowel syndrome (IBS) is a functional disorder, with prevalence 10-20%. Endoscopy is the gold standard for detecting and quantifying IBDs, but due to its low prevalence (in Japan: 152x105 persons), it turns negative in most cases, it is expensive, uncomfortable and risky for the patient. F-Calprotectin is a fecal marker of intestine inflammation that can be used as a pre-endoscopic technique to rule out IBDs. EliA Calprotectin 2 is expected to be launched into the Japanese market in 2017. The present study aims at evaluating the costeffectiveness of a) EliA Calprotectin 2 test compared to the usage of serologic markers CRP and ESR, b) combined usage of these tests, and c) gold standard to distinguish IBD from IBS in Japan. Methodology: A 18-weeks Markov model was developed for each diagnostic strategy, simulating 1000 patients presenting to PC with unspecific gastrointestinal symptoms. Outcomes include cost savings, cost per corrected IBD diagnosed, and colonoscopies reduction (including their complications). Uncertainty was addressed with sensitivity analysis. Findings: EliA Calprotectin 2 is cost-effective compared to CRP+ESR, and to colonoscopy; it: 1) Results in more corrected IBD diagnoses at a lower price; 2) Reduces the number of unnecessary endoscopies, increasing the number of correctly diagnosed IBD (N=63) and IBS (N=26) patients. Conclusion: Results show that the usage of EliA Calprotectin 2 as pre-endoscopic diagnostic tool is associated with less colonoscopies, and important cost savings ascribable to reduced resource utilization. F-Calprotectin is a dominant strategy in relation to the comparators; it should be recommended for reimbursement in Japan, and can be considered as good value for money for the health insurance system.
Barbara Mascialino works as Health Economics and Outcome Research Manager at Thermo Fisher Scientific Immuno Diagnostics in Sweden. Barbara is a nuclear physicist with more than 15 years of experience in epidemiology, modelling and data analysis.