Studies in South-East Asia |
Lubell et al27 | Laos | Patients with CRP >20 mg/L or positive scrub typhus RDT are prescribed an antibiotic; patients with positive dengue RDT do not receive antibiotics. If tests are negative, antibiotics are prescribed at a rate of 38% Mean cost of CRP test was US$1.5, mean cost of a course of antibiotics was US$0.5. Mortality rate for bacterial infections without appropriate treatment was 1% (each death represents a mean loss of 45 life-years). Self-limiting/treated infections have a disability weight of 0.053.
| CRP RDT prevented 0.017 DALYs. Median ICER for CRP RDT was US$94. CRP testing is likely to be cost-effective even at low willingness-to-pay thresholds. The CRP tests was approximately 80% likely to be cost-effective at a willingness-to-pay threshold of US$1400 (approximating the Laos GDP/capita).
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Lubell et al29 | Vietnam | Unit cost of US$0.5 to US$3 per CRP test. Economic cost of AMR of US$0 to US$14 per full course. No difference in clinical outcomes between CRP-tested and non-CRP-tested patients, benefits relate only to the societal costs of AMR averted due to lower prescribing.
| At an AMR cost of US$4.1 and unit costs of US$0.5, CRP testing has a positive net-benefit if adherence to test results is >70%. At an AMR cost of US$4.1 and unit costs of US$1, CRP testing has a positive net-benefit if adherence to test results is ≥80%. A higher AMR cost of US$14.1 implies a positive net-benefit if adherence is >60%, even at US$3 per unit.
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