Given the importance, cost-effectiveness and prevalence of ancillary studies, as well as the wide use of CTMSs, it is surprising that general-purpose ancillary study management systems (ASMSs) have not been discussed in the research literature, either as stand-alone systems or as extensions to CTMSs.
Despite evidence of cost-effectiveness in low prevalence areas [ 11], routine 'opt-out' testing was not recommended, except in areas with adult prevalence > 0.2%.
With the given set of assumptions and using USD 200 250 as a cost-effectiveness target, TB prevalence around 1.5% was identified as the decision-making-point whether to employ X-ray screening for all.
Models highlight the sensitivity of cost-effectiveness results to HIV prevalence [ 40], suggesting challenges for efficient delivery of these interventions in very low HIV prevalence settings.
Computerized simulations are used to investigate the performance of sampling strategies in correctly classifying schools according to treatment needs and their cost-effectiveness in identifying high prevalence schools.
However, since the main determinant of the cost-effectiveness results is HIV prevalence, these results are likely generalizable to other regions of India.
NICE undertook a cost-effectiveness analysis using lower prevalence estimates and limited outcomes and still showed screening for GDM to be cost-effective.
Although modeling indicates that routine testing is cost-effective, with estimates generally less than $70,000 per Quality-adjusted life year (QALY) gained compared to prior testing policies, cost-effectiveness worsens as the prevalence of undiagnosed HIV infection in the local population decreases [ 26].
44 47 Critically, the cost-effectiveness varies substantially by HCV prevalence, 47 and the estimated US prevalence is higher than that of many other developed countries.
While modelling in a Sub-Saharan African setting [ 9], revealed that a single NVP dose provided to both mother and baby could be highly cost-effective in high sero-prevalence settings, the cost-effectiveness of NVP therapy in an Asian setting where prevalence is lower is unknown.
