We evaluated the cost-effectiveness of test-and-treat scenarios for vaginitis, scenarios based on clinical and microscopic examination (CME), nucleic acid amplification testing (NAAT), or nonamplified nucleic acid probe (probe) testing. The symptom resolution outcome and the payer cost of diagnosis and treatment were estimated in decision analytical models in a hypothetical patient population. Compared with probe testing, NAAT resulted in symptom resolution in more patients (615 versus 475 per 1000 tested) at a cost of $210 per incremental symptom resolution, a cost lower than the willingness to pay for symptom resolution ($871) implied by payer coverage for probe testing. Following a negative CME, the NAAT scenario resulted in symptom resolution in more patients (650 per 1000 patients tested) than did either CME (525) or the CME probe testing–based scenario (602) at incremental cost-effectiveness ratios lower than the willingness to pay implied by coverage for CME. Therefore, NAAT is likely to cost-effectively improve health outcomes for patients with vaginitis.

我们评估了阴道炎测试治疗方案，基于临床和显微镜检查（CME），核酸扩增测试（NAAT）或非扩增核酸探针（probe）测试的方案的成本效益。在假设的患者人群中，在决策分析模型中估计了症状缓解的结果以及诊断和治疗的付款方费用。与探针测试相比，NAAT导致更多患者的症状解决（615对475对每千个测试），每增加一个症状解决费用为210美元，这一费用低于付款人为支付的症状解决意愿支付的意愿（871美元）。探针测试。在CME否定之后，NAAT方案比CME（525）或基于CME探针测试的方案（602）导致更多的患者（每1000名接受测试的患者650名）症状缓解，而成本效益比却低于承保范围所隐含的支付意愿对于CME。因此，NAAT可能可以经济有效地改善阴道炎患者的健康状况。