Cost of illness of Mycoplasma genitalium in Australia: an incidence-based approach incorporating resistance-guided therapy

As macrolide-resistant Mycoplasma genitalium (MG) becomes more prevalent, resistance-guided therapy (RGT) for MG has been recommended in clinical guidelines to improve first-line antibiotic selection and increase cure rates. This study adopted an incidence-based approach and a healthcare sector perspective to measure the cost of illness of MG in Australia. Two management strategies, RGT and non-RGT, were examined. A decision tree model was developed to replicate the clinical pathways among non-pregnant women, men who have sex with men (MSM) and men who have sex with women (MSW). The burden of managing a woman diagnosed with MG was lower under RGT compared to non-RGT (AUD 249 vs. 283). For MSM, the expected per-person cost was AUD 240 and AUD 279 under RGT and non-RGT. For MSW, non-RGT would cost an additional AUD 23. Overall, this study found that the economic burden of MG under RGT is lower than under non-RGT for both women and men in Australia. RGT offers cost savings while improving MG clinical management and helping to slow the spread of macrolide resistance.