Ten-year health impact, economic impact and return on investment of the South African molecular diagnostics programme for HIV, tuberculosis and SARS-CoV-2.

IF 7.1 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

BMJ Global Health Pub Date : 2024-12-03 DOI:10.1136/bmjgh-2024-015830

Brooke E Nichols, Alexandra de Nooy, Naseem Cassim, Lucia Hans, Manuel Pedro da Silva, Kamy Chetty, Kyra H Grantz, Alvin X Han, Andrew N Phillips, Lise Jamieson, Lesley E Scott, Wendy S Stevens

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引用次数: 0

Abstract

Introduction: To ensure there is adequate investment into diagnostics, an understanding of the magnitude of impact and return on investment is necessary. We, therefore, sought to understand the health and economic impacts of the molecular diagnostic programme in South Africa, to deepen the understanding of the broad value of diagnostics and guide future healthcare investments.

Methods: We calculated the 10-year (where data were available) total cost and disability-adjusted life-years (DALYs) averted associated with molecular testing for tuberculosis diagnosis (2013-2022), HIV viral load monitoring (2013-2022), early infant diagnosis of HIV infection (2013-2022) and SARS-CoV-2 testing (2020-2022), based on the actual number of molecular tests conducted in South Africa for the respective time periods. We then calculated the economic value associated with those health gains and subsequent return on investment.

Results: Since the inception of the molecular diagnostics programme in South Africa, approximately 4.3 million DALYs (uncertainty range (UR): 2.8-5.8 million) have been averted as a direct consequence of this programme. This has generated an estimated US$28.3 billion in economic value due to these health gains (UR$18.4-UR$38.7 billion). The return on investment varied by specific diagnostic test (20.3 (UR 15.2-25.4) for tuberculosis, 7.7 (UR 1.6-13.9) for HIV viral load testing, 63.0 (UR 63.0-65.5) for early infant diagnosis of HIV and 2.5 (UR 0.7-4.6) for SARS-CoV-2), for an average of 13.9 (UR 9.0-18.9) for the entire molecular diagnostics programme or US$13.9 of value for each UR$1 invested.

Conclusions: The molecular diagnostics programme in South Africa generated a significant amount of health gains and economic value associated with these health gains. The return on investment rivals other high-impact public health interventions such as childhood vaccination. The molecular diagnostics programme in South Africa is highly impactful and will continue to be an excellent investment in South African public health expenditure.

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南非艾滋病毒、结核病和SARS-CoV-2分子诊断方案的十年健康影响、经济影响和投资回报。

简介：为了确保对诊断进行足够的投资，有必要了解影响的程度和投资回报。因此，我们试图了解南非分子诊断项目对健康和经济的影响，以加深对诊断广泛价值的理解，并指导未来的医疗投资。方法：我们根据南非在各自时期进行的分子检测的实际次数，计算了与结核病诊断（2013-2022年）、艾滋病毒载量监测（2013-2022年）、婴儿早期艾滋病毒感染诊断（2013-2022年）和SARS-CoV-2检测（2020-2022年）相关的10年（有数据的）总成本和残疾调整生命年（DALYs）。然后，我们计算了与这些健康收益和随后的投资回报相关的经济价值。结果：自南非分子诊断项目启动以来，作为该项目的直接结果，已经避免了大约430万伤残调整生命年（不确定范围（UR）： 280 - 580万）。由于这些健康收益，估计产生了283亿美元的经济价值（184亿至387亿瑞郎）。投资回报率因具体诊断测试而异(结核病20.3（15.2-25.4里亚尔），艾滋病毒载量测试7.7（1.6-13.9里亚尔），艾滋病毒早期婴儿诊断63.0（63.0-65.5里亚尔），SARS-CoV-2的2.5（0.7-4.6里亚尔），整个分子诊断计划的平均回报率为13.9（9.0-18.9里亚尔），即每投资1里亚尔可获得13.9美元的价值。结论：南非的分子诊断方案产生了大量的健康收益和与这些健康收益相关的经济价值。投资回报可与儿童疫苗接种等其他高影响力公共卫生干预措施相媲美。南非的分子诊断方案极具影响力，并将继续成为南非公共卫生支出的一项极好的投资。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMJ Global Health Medicine-Health Policy

CiteScore

11.40

自引率

4.90%

发文量

429

审稿时长

18 weeks

期刊介绍： BMJ Global Health is an online Open Access journal from BMJ that focuses on publishing high-quality peer-reviewed content pertinent to individuals engaged in global health, including policy makers, funders, researchers, clinicians, and frontline healthcare workers. The journal encompasses all facets of global health, with a special emphasis on submissions addressing underfunded areas such as non-communicable diseases (NCDs). It welcomes research across all study phases and designs, from study protocols to phase I trials to meta-analyses, including small or specialized studies. The journal also encourages opinionated discussions on controversial topics.