Sex Transm Dis. 2025 Feb 20. doi: 10.1097/OLQ.0000000000002143. Online ahead of print.
ABSTRACT
BACKGROUND: Pelvic inflammatory Disease (PID) disproportionately impacts adolescents and young adult women. The Technology-Enhanced Community Health Nursing (TECH-N) trial demonstrated the potential benefit of a novel community health intervention for adolescents with PID. We assess the cost-effectiveness of TECH-N compared to standard care.
METHODS: We constructed a cohort Markov model to assess the cost-effectiveness of TECH-N for adolescents with PID in an urban setting. The model used nine health states: PID, two states for STIs, four states for PID sequelae, recovery and deceased states. The cohort consisted of 18-year-old female adolescents with mild to moderate PID. Transition probabilities were derived from the TECH-N clinical trial and published literature. Health state utilities were derived from published literature. Intervention costs were estimated using TECH-N data, and health state costs were derived from published literature and public databases. The model took a health system perspective over a 10-year time horizon. Sensitivity analyses were used to assess uncertainty. Cost-effectiveness was estimated using the discounted incremental cost-effectiveness ratio (ICER) with effects measured in quality-adjusted life years (QALYs).
RESULTS: Over ten years, the TECH-N cohort generated 8.16 QALYs per individual at a cost of $20,419 compared to standard care with 8.14 QALYs costing $20,492. The resulting ICER was negative since the intervention produced more QALYs at a lower cost; suggesting TECH-N is cost-saving.
CONCLUSIONS: Our model suggests the TECH-N intervention yields better outcomes at lower overall costs. Additionally, the nature of TECH-N lends itself to being coupled with other home-health/community strategies, which could further improve its value proposition.
PMID:39976993 | DOI:10.1097/OLQ.0000000000002143
