ORGANIZATIONAL AND BUDGET IMPACT IN FRANCE OF A SALIVA MICRORNA TEST FOR ENDOMETRIOSIS
Author(s)
Sandrine Bourguignon, MSc, PhD1, Enguérand Dautel, PharmD2, Andrew SPIERS, MDs3, Isabelle Durand-Zaleski, MPP, PhD, MD4.
1Global Market access and data generation lead, Ziwig, BONDOUFLE, France, 2RWEALITY, Paris, France, 3Department of Obstetrics, Gynecology and Reproductive Medicine,, Angers University Hospital, ANGERS, France, 4Assistance Publique Hopitaux de Paris URCEco, Paris, France.
1Global Market access and data generation lead, Ziwig, BONDOUFLE, France, 2RWEALITY, Paris, France, 3Department of Obstetrics, Gynecology and Reproductive Medicine,, Angers University Hospital, ANGERS, France, 4Assistance Publique Hopitaux de Paris URCEco, Paris, France.
OBJECTIVES: Endometriosis affects 10% of women of reproductive age globally, with a 7-10-year diagnostic delay, driving substantial healthcare resource use through repeated imaging investigations, medical wandering and diagnostic laparoscopy. We assessed the 5-year budget impact, and the 15-year organizational impact, of introducing a non-invasive saliva-based microRNA diagnostic test after inconclusive imaging examination in the French care pathway.
METHODS: A 3-state mutually exclusive Markov model (comprising No endometriosis, Undiagnosed endometriosis and Diagnosed endometriosis) compared current standard of care for women with normal or equivocal imaging versus the introduction of the microRNA diagnostic test. The target population was estimated using an epidemiological approach including incident patients post-imaging. Unit costs were derived from a real-world French claims database (EGB, 2011-2018) covering costs of hospitalizations, drugs, imaging, laboratory tests, consultations and transport; scenario analyses were conducted using updated cost data. Primary organizational outcomes included diagnostic laparoscopies avoided and years of diagnostic wandering averted, projected 15-year horizons.
RESULTS: The cumulative budget impact was cost saving, with estimated savings of €1.0 billion from the Statutory Health Insurance perspective in the base case. Organizational impacts were substantial: 63,867 diagnostic laparoscopies avoided and 212,889 years of diagnostic wandering averted over 5 years at a population level. These two organizational drivers explained the majority of avoided resource use. Introduction of the microRNA diagnostic test in primary care amplified both effects, maximizing avoided diagnostic surgeries and minimising pre-diagnostic resource consumption.
CONCLUSIONS: A non-invasive saliva-based microRNA test introduced after inconclusive imaging may deliver major organizational benefits while remaining cost-saving for the French Statutory Health Insurance. The model was restricted to the diagnostic phase, it did not capture downstream treatment costs, clinical outcomes, fertility related consequences or quality of life effects. The test is set to act as a structural lever for care pathway transformation rather than a marginal diagnostic refinement.
METHODS: A 3-state mutually exclusive Markov model (comprising No endometriosis, Undiagnosed endometriosis and Diagnosed endometriosis) compared current standard of care for women with normal or equivocal imaging versus the introduction of the microRNA diagnostic test. The target population was estimated using an epidemiological approach including incident patients post-imaging. Unit costs were derived from a real-world French claims database (EGB, 2011-2018) covering costs of hospitalizations, drugs, imaging, laboratory tests, consultations and transport; scenario analyses were conducted using updated cost data. Primary organizational outcomes included diagnostic laparoscopies avoided and years of diagnostic wandering averted, projected 15-year horizons.
RESULTS: The cumulative budget impact was cost saving, with estimated savings of €1.0 billion from the Statutory Health Insurance perspective in the base case. Organizational impacts were substantial: 63,867 diagnostic laparoscopies avoided and 212,889 years of diagnostic wandering averted over 5 years at a population level. These two organizational drivers explained the majority of avoided resource use. Introduction of the microRNA diagnostic test in primary care amplified both effects, maximizing avoided diagnostic surgeries and minimising pre-diagnostic resource consumption.
CONCLUSIONS: A non-invasive saliva-based microRNA test introduced after inconclusive imaging may deliver major organizational benefits while remaining cost-saving for the French Statutory Health Insurance. The model was restricted to the diagnostic phase, it did not capture downstream treatment costs, clinical outcomes, fertility related consequences or quality of life effects. The test is set to act as a structural lever for care pathway transformation rather than a marginal diagnostic refinement.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE417
Topic
Economic Evaluation, Health Technology Assessment, Medical Technologies
Topic Subcategory
Budget Impact Analysis, Novel & Social Elements of Value
Disease
Personalized & Precision Medicine, Reproductive & Sexual Health, Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)