Rapid diagnostic test for G6PD deficiency in Plasmodium vivax-infected men: a budget impact analysis based in Brazilian Amazon

Trop Med Int Health. 2017 Jan;22(1):21-31. doi: 10.1111/tmi.12800. Epub 2016 Nov 14.

Abstract

Objective: The aim of this study was to estimate the incremental budget impact (IBI) of a rapid diagnostic test to detect G6PDd in male patients infected with Plasmodium vivax in the Brazilian Amazon, as compared with the routine protocol recommended in Brazil which does not include G6PDd testing.

Methods: The budget impact analysis was performed from the perspective of the Brazilian health system, in the Brazilian Amazon for the years 2013, 2014 and 2015. The analysis used a decision model to compare two scenarios: the first consisting of the routine recommended in Brazil which does not include prior diagnosis of dG6PD, and the second based on the use of RDT CareStart™ G6PD (CS-G6PD) in all male subjects diagnosed with vivax malaria. The expected implementation of the diagnostic test was 30% in the first year, 70% the second year and 100% in the third year.

Results: The analysis identified negative IBIs which were progressively smaller in the 3 years evaluated. The sensitivity analysis showed that the uncertainties associated with the analytical model did not significantly affect the results.

Conclusion: A strategy based on the use of CS-G6PD would result in better use of public resources in the Brazilian Amazon.

Keywords: Plasmodium vivax; Glucosa-6-fosfato deshidrogenasa; Hemólisis; Malaria; Primaquina; analyse d'impact budgétaire; análisis presupuestario; budget impact analysis; glucose-6-phosphate dehydrogenase; glucose-6-phosphate déshydrogénase; haemolysis; hémolyse; malaria; paludisme; primaquine.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antimalarials / therapeutic use
  • Brazil / epidemiology
  • Budgets
  • Decision Support Techniques
  • Diagnostic Techniques and Procedures / economics*
  • Glucosephosphate Dehydrogenase Deficiency / diagnosis*
  • Glucosephosphate Dehydrogenase Deficiency / epidemiology*
  • Humans
  • Malaria, Vivax / drug therapy
  • Malaria, Vivax / epidemiology*
  • Male
  • Mass Screening / economics*
  • Models, Econometric
  • Primaquine / therapeutic use
  • Time Factors

Substances

  • Antimalarials
  • Primaquine