Cost-effectiveness of fecal calprotectin used in primary care in the diagnosis of IBD

Cost-effectiveness of fecal calprotectin used in primary care in the diagnosis of inflammatory bowel disease

Design: We constructed a decision analytic tree with a 1-year time horizon. The cut-off level of 100 µg/g was used for FC testing. Probabilistic analyses were conducted for the base case and all scenarios.

Setting: Canadian health sector perspective.

Population: A hypothetical cohort of adult patients presenting with gastrointestinal symptoms in the primary care setting.

Interventions: FC test compared with blood test.

Main outcome measures: Costs, quality-adjusted life years (QALYs), incremental cost-effectiveness ratio (ICER) of FC test expressed as cost per QALY gained compared with blood test and time to IBD diagnosis.

Results: FC testing is expected to cost more ($C295.1 vs $C273.9) than standard practice but yield little higher QALY (0.751vs0.750). The ICER of FC test was $C20 323 per QALY. Probabilistic analysis demonstrated that at a willingness-to-pay threshold of $C50 000 per QALY, there was 81.3% probability of FC test being cost-effective. The use of FC test in primary care reduced the time to IBD diagnosis by 40.0 days (95% CI 16.3 to 65.3 days), compared with blood testing alone.

Conclusions: Based on this analysis of short-term outcomes, screening adult patients in primary care using FC test at a cut-off level of 100 µg/g is expected to be cost-effective in Canada.