We explored the use of a rapid, on-demand human papillomavirus (HPV) test. Interviews with UK experts revealed that a co-located, on-demand HPV test following cytology could reduce the time to cervical screening results by up to a week, with a near-patient primary HPV test followed by cytology triage could radically change the testing paradigm. A follow-up tool we built in Excel was used to understand cervical screening burden and HPV testing across Europe.
Sexual Health & HIV
Improving clinical decision making and patient management
The Aquarius team has a breadth of experience in sexual health research and our work in this area has informed international policy and patient care. Projects within this field include health economic evaluations, assessing the impact of new innovations such as rapid diagnostics, measuring the burden of disease, evaluating alternative screening strategies and creating interactive tools to inform decisions making around adoption of new technologies.
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Case Studies
The cost of pelvic inflammatory disease and potential cost-savings of chlamydia screening
We worked with clinicians from St Georges University who had published a trial estimating the incidence of pelvic inflammatory disease (PID) among women screened and unscreened for chlamydia. Patient data was analysed, and the average cost of managing PID was estimated to be £163 in community and hospital settings, and that over £60,000 could be saved in London alone from screening for chlamydia. This paper has been cited widely and results have informed policy and further modelling studies.
Estimating the true costs of splitting HIV antiretroviral drugs
There is a temptation to switch to cheaper generic antiretroviral drugs compared to fixed-dose combination therapy for HIV patients in the interests of cost savings. However, in our analysis we found that there were no costs saved when including all patient care including drugs, additional clinic visits and monitoring. We also found that switching may cause confusion for some patients, risking loss of adherence. This evidence can help commissioners make better policy decisions about drug provision.
Increased efficiency and improved treatment for stable HIV patients in England
Collaborators at St Georges Hospital wanted to understand the impact of changing service provision for stable HIV patients, as no evidence existed on what was best for clinics. We built a tool in Excel, and results indicated that 6-monthly appointments and 3-monthly home delivery of drugs is the cheapest option and could yield £2000 savings per patient, translating to an annual cost reduction of ~£8 million for the estimated 4000 eligible patients not currently on home delivery in England in 2012.
Case Studies
Cervical screening and HPV testing: Opportunities for rapid tests
We explored the use of a rapid, on-demand human papillomavirus (HPV) test. Interviews with UK experts revealed that a co-located, on-demand HPV test following cytology could reduce the time to cervical screening results by up to a week, with a near-patient primary HPV test followed by cytology triage could radically change the testing paradigm. A follow-up tool we built in Excel was used to understand cervical screening burden and HPV testing across Europe.
The cost of pelvic inflammatory disease and potential cost-savings of chlamydia screening
We worked with clinicians from St Georges University who had published a trial estimating the incidence of pelvic inflammatory disease (PID) among women screened and unscreened for chlamydia. Patient data was analysed, and the average cost of managing PID was estimated to be £163 in community and hospital settings, and that over £60,000 could be saved in London alone from screening for chlamydia. This paper has been cited widely and results have informed policy and further modelling studies.
Estimating the true costs of splitting HIV antiretroviral drugs
There is a temptation to switch to cheaper generic antiretroviral drugs compared to fixed-dose combination therapy for HIV patients in the interests of cost savings. However, in our analysis we found that there were no costs saved when including all patient care including drugs, additional clinic visits and monitoring. We also found that switching may cause confusion for some patients, risking loss of adherence. This evidence can help commissioners make better policy decisions about drug provision.
Increased efficiency and improved treatment for stable HIV patients in England
Collaborators at St Georges Hospital wanted to understand the impact of changing service provision for stable HIV patients, as no evidence existed on what was best for clinics. We built a tool in Excel, and results indicated that 6-monthly appointments and 3-monthly home delivery of drugs is the cheapest option and could yield £2000 savings per patient, translating to an annual cost reduction of ~£8 million for the estimated 4000 eligible patients not currently on home delivery in England in 2012.
Publications
An Implementation Tool For US Professionals: First Void Urine Self-Sampling for Primary HPV Cervical Cancer Screening
The national coverage of cervical cancer screening in the US is falling, with about 1 in 4 women not up to date with screening1. Under-screened women bear the greatest burden of disease. Evidence shows 60-64% of American women diagnosed with cervical cancer were unscreened, highlighting the need to explore alternative methods to improve access2-4. In Read More >
The cost-effectiveness of point of care tests for chlamydia and gonorrhoeae in sexual health clinics
Publications
An Implementation Tool For US Professionals: First Void Urine Self-Sampling for Primary HPV Cervical Cancer Screening
The national coverage of cervical cancer screening in the US is falling, with about 1 in 4 women not up to date with screening1. Under-screened women bear the greatest burden of disease. Evidence shows 60-64% of American women diagnosed with cervical cancer were unscreened, highlighting the need to explore alternative methods to improve access2-4. In Read More >
The cost-effectiveness of point of care tests for chlamydia and gonorrhoeae in sexual health clinics
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