Aquarius Population Health

Our paper on the cost of using PCR-based respiratory panel assays for patients with pneumonia was published this week in BMC Pulmonary Medicine. This work, funded by the Innovative Health Initiative (IHI), compared the cost of using standard diagnostic tests with the cost of using either an upper respiratory pathogen PCR-based panel test, a lower respiratory pathogen panel or both. Data on how many patients are tested for which pathogens and the cost of diagnostic testing for patients with community-acquired pneumonia (CAP) admitted to hospital were collected via an online survey. The analysis found that in the UK, France and Spain, using a combination of both panel tests reduced costs associated with diagnostic testing compared with standard of care (SoC) testing. These findings support decision-makers in selecting the types of diagnostic tests used for patients admitted to hospital with CAP.

Community-acquired pneumonia (CAP) can be caused by infection with a number of different pathogens and significantly contributes to morbidity and mortality on a global scale. In Europe, the annual costs associated with hospital admission of patients with CAP have been estimated at around €5.7 billion. Part of these costs can be attributed to the many microbiological diagnostic tests used for CAP patients which typically include culture (of blood, sputum, or bronchoalveolar lavage sample), urinary antigen tests and numerous PCR tests, and can be expensive and time-consuming.

GeneFirst, a molecular diagnostics company based in Oxfordshire (UK), has two PCR-based respiratory panel tests, one for upper respiratory tract infections (URTI) (Respiratory 1 Panel) and one for lower respiratory tract infections (LRTI) (Respiratory 3 Panel). The high-throughput panels can be used individually or in parallel and have a turnaround time of 5.5 hours. They can replace the use of individual PCR diagnostic tests, such as the PCR test for COVID-19, and include tests for additional pathogens that might not otherwise be assessed.

As part of a large grant funded project (awarded to GeneFirst and four collaborating organisations), we assessed the potential financial impact of integrating the respiratory panels into clinical practice. A cost-comparison model was developed to compare SoC with three panel testing strategies: a) Panel 1 (URTI); b) Panel 3 (LRTI); c) Panel 1 and Panel 3 used in parallel (used in addition to diagnostic tests that would not be replaced with the panel tests). To inform the model we used interviews and an online survey targeting senior clinicians in the UK, France and Spain. The survey collected specific data on key parameters, including the proportion of patients undergoing different diagnostic tests and the costs of diagnostic testing to the health system.

The results indicated that all three strategies where one or both respiratory panels were used cost less than SoC, while the combination of using both panel tests in parallel cost the least, resulting in cost savings for immunocompetent and immunocompromised patients.

These findings provide evidence that incorporating the respiratory panel tests would reduce the average cost of diagnostics for patients admitted to hospitals with CAP in the UK, France and Spain. The findings offer valuable insights for decision-makers considering the use of these panels in hospital laboratories.

The full paper is now available open access on the BMC Pulmonary Medicine website.

Huntington S, Miners L, Lee N, et al. An economic evaluation of two PCR-based respiratory panel assays for patients admitted to hospital with community-acquired pneumonia (CAP) in the UK, France and Spain. BMC Pulm Med. 2023 Jun 21;23(1):220. doi:10.1186/s12890-023-02516-2.

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