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Cost-Effectiveness Analysis of the Messenger RNA Test (Aptima®) Compared With the Polymerase Chain Reaction DNA Test
Paula Benítez-Ospina1, Jairo Amaya-Guio2, Cristian E Navarro3
1Gynecology and Obstetrics Department, Universidad El Bosque, Bogotá, Colombia.
Objectives:
To determine the cost-effectiveness of the Aptima® test compared with the polymerase chain reaction DNA test for the detection of human papillomavirus (HPV) infection in women over 30 years of age from the perspective of the Colombian health system.
Methods:
A decision tree model was developed from the perspective of the healthcare system, using a hypothetical cohort of 2000 unvaccinated women over 30 years of age and a 1-year time horizon. Model inputs were obtained from a review of the literature and national institutional databases. The decision rule was the incremental cost-effectiveness ratio (ICER) per correctly diagnosed case of HPV infection. To assess the robustness of the model, both univariate deterministic and probabilistic sensitivity analyses were conducted. The currency used was the US dollar for the year 2024, using a cost-effectiveness threshold of $7949, equivalent to 1 gross domestic product per capita in Colombia for 2024.
Results:
The Aptima test was found to be cost-effective, with an ICER of $2706 per correctly diagnosed case. In the deterministic analysis, Aptima remained cost-effective in the majority of evaluated scenarios. The variables with the greatest impact on the ICER were the specificity of both tests and the sensitivity of the Aptima test. The Aptima test was cost-effective in 72.16% of the Monte Carlo simulations.
Conclusions:
The Aptima test represents a cost-effective strategy for screening HPV infection in women over 30 years of age, compared with the polymerase chain reaction DNA test, within the context of the Colombian health system.
