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Impact Of A Novel Ibs Diagnostic Blood Panel For Mexico: Cost Implications To The Mexican Private Practice For Diarrhea Predominant Irritable Bowel Syndrome (Ibs-D)

      Objectives

      Irritable bowel syndrome presents a significant burden to patients and to the healthcare system in Mexico. An IBS diagnosis is based on Rome criteria; however, laboratory tests and diagnostic procedures are required to exclude organic conditions such as inflammatory bowel disease (IBD). A new IBS diagnostic blood panel has been developed which tests for the presence of two biomarkers associated with IBS-D. This analysis assesses the cost impact to the Mexican private practice.

      Methods

      Budget impact analysis (BIA) was based on a cost-minimization (CM) decision model developed to compare the costs associated with two possible diagnostic pathways: (1) diagnostic pathway with a new IBS diagnostic blood panel and (2) exclusionary diagnostic pathway (i.e. standard of care) and applied to the Mexican population. Model structure was based on current literature and guidance from IBS expert clinicians. Direct medical expenses for laboratory tests, diagnostic procedures and visit costs were included in Mexican pesos and weighted by utilization rates provided by practicing gastroenterologists in private practice in Mexico. The indirect cost estimate was based on the literature and only included absenteeism, adjusted for per capita income. The base case assumes that 75% of patients who receive a positive test result will proceed to IBS-D treatment. For the BIA, it is assumed that 30% of IBS-D patients will seek care, and clinicians use the test for 50% of patients presenting with IBS-D symptoms.

      Results

      The CM model predicts per patient savings with the IBS diagnostic panel of Mex$1,688 (Mex$35,019 vs. Mex$36,707). Cost neutrality occurs if 44% of the “positive test” patients receive IBS-D treatment. The BIA predicts a net savings to the Mexican healthcare system of Mex$794,158,235.

      Conclusions

      Inclusion of a novel IBS diagnostic blood panel in the diagnostic process has the potential for significant cost savings due to the avoidance of downstream testing.