Cost-Effectiveness of a Digital Symptom Checker for Endometriosis

Overview

A Markov decision process model evaluated the digital symptom checker (Flo SC) for endometriosis, showing it reduced diagnostic delay by 4.36 years, saved $5196.22 per patient, and gained 0.049 QALYs over 40 years. The intervention demonstrated a positive incremental net monetary benefit, confirming cost-effectiveness from a societal perspective.

Background

Digital symptom checkers (SCs) assist individuals in self-assessing symptoms and deciding on care-seeking, with growing adoption in healthcare. Endometriosis is a chronic gynecological condition often diagnosed late due to nonspecific symptoms and limited non-invasive tests, leading to high societal costs. Early identification through digital SCs may reduce diagnostic delays and improve outcomes. Prior economic evaluations have not addressed the cost-effectiveness of digital SCs for endometriosis, creating a gap this study aims to fill.

Data Highlights

Key Findings

• Flo SC reduced diagnostic delay for endometriosis by an average of 4.36 years compared to standard care.
• The digital SC saved $5196.22 per patient in total costs, primarily from direct medical cost reductions.
• Patients using Flo SC gained an incremental 0.049 quality-adjusted life years (QALYs) over 40 years.
• The incremental net monetary benefit was $10,089 at a $100,000/QALY willingness-to-pay threshold, indicating cost-effectiveness.
• Probabilistic sensitivity analysis confirmed robustness, with INMB of $12,398.92 (95% CI: $11,893.11–$12,904.72).
• Scenario analyses showed cost-effectiveness was maintained when sensitivity and specificity were ≥0.7, compliance >45%, and time horizon ≥10 years.

Clinical Implications

Implementing digital symptom checkers like Flo SC can facilitate earlier diagnosis of endometriosis, reducing diagnostic delays and associated healthcare costs. Clinicians and health systems may consider integrating such tools to improve patient outcomes and optimize resource utilization, especially when patient compliance and test accuracy are adequate.

Conclusion

This study provides the first economic evaluation demonstrating that a digital symptom checker for endometriosis is a cost-effective strategy that improves health outcomes and reduces costs over the long term. Digital SCs represent a promising approach to address diagnostic delays in underrecognized conditions.

References

1. Cost-Effectiveness Analysis of a Digital Symptom Checker for Endometriosis Utilizing a Markov Decision Process Model