Author:
Miners Lisa,Huntington Susie,Lee Nathaniel,Turner Katy M. E.,Adams Elisabeth
Abstract
Abstract
Background
On admission to hospital, patients with community-acquired pneumonia (CAP), undergo extensive diagnostic testing. Two high-throughput laboratory-based PCR panels which return a result in 5.5 hours (h) have been developed to test for pathogens commonly associated with upper (Respiratory 1 Panel) and lower (Respiratory 3 Panel) respiratory tract infections (GeneFirst, Oxford). These could replace multiple diagnostic tests currently used.
Methods
An online survey, completed by senior clinicians in the UK, France and Spain, was used to collect data on the diagnostic testing of immunocompetent and immunocompromised adults admitted to hospital with CAP, including the cost of diagnostics. Data were used to inform a cost-comparison model. For each country, the average cost of diagnostic testing per patient was calculated separately for immunocompetent and immunocompromised patients.
The model compared three testing strategies with standard of care (SoC). In the Panel 1 strategy, the Respiratory 1 Panel was used for patients that would otherwise have tests which could be replaced by Respiratory 1 Panel, equivalent strategies for Respiratory 3 Panel and for both panels combined were assessed.
Results
In total, 48 surveys were completed (UK = 17; France = 15; Spain = 16). Compared with SoC, the Panel 1 + 3 strategy was most favourable, resulting in cost savings for immunocompetent and immunocompromised patients respectively, of €22.09 (£18.50) and €26.12 (£21.88) in the UK, €99.60 and €108.77 in France and €27.07 and €51.87 in Spain.
Conclusion
In all three countries, the use of these respiratory panels could reduce the average cost of diagnostics used for patients admitted to hospital with CAP.
Publisher
Springer Science and Business Media LLC
Subject
Pulmonary and Respiratory Medicine
Reference20 articles.
1. Walden AP, Clarke GM, McKechnie S, Hutton P, Gordon AC, Rello J, Chiche J-D, Stueber F, Garrard CS, Hinds CJ, et al. Patients with community acquired pneumonia admitted to european intensive care units: an epidemiological survey of the genosept cohort. Crit Care. 2014;18:R58. https://doi.org/10.1186/cc13812.
2. Morgan A, Glossop A. Severe Community-Acquired Pneumonia BJA Educ. 2016;16:167–72. https://doi.org/10.1093/bjaed/mkv052.
3. NICE Pneumonia in Adults: Quality Standard 2016.
4. Welte T, Torres A, Nathwani D. Clinical and economic burden of community-acquired pneumonia among adults in Europe. Thorax. 2012;67:71–9. https://doi.org/10.1136/thx.2009.129502.
5. Lim, W.S.; Smith, D.; Wise, M.; Welham, S. 2015 - Annotated BTS Guideline for the Management of CAP in Adults (2009): Summary of Recommendations 2015.