Adding point-of-care testing (POCT) to outpatient triage of acute respiratory infections (ARI) can reduce unnecessary antibiotics and antibiotic-related adverse events (AEs), resulting in substantial cost savings, according a new study published in the Journal of Medical Economics,
Health care savings were estimated using a budget impact analysis based on UK National Institute for Health and Care Excellence data and direct costs (antibiotics, AEs, POCTs) derived from published literature.
Otitis media, sinusitis, pharyngitis and bronchitis were considered the most common ARIs. Antibiotic-related AE costs were calculated using re-consultation costs for anaphylaxis, Stevens-Johnson syndrome, allergies/diarrhea/nausea and C difficile infection.
The study found that 50% (7,718,283) of ARI consultations resulted in antibiotics, whereas guideline-based prescribing suggests appropriate antibiotic prescriptions are warranted in 9% (1,444,877) of ARI consultations.
Direct antibiotic costs for actual ARI consultations associated with antibiotics was £24,003,866 versus £4,493,568 for guideline-based, “appropriate” antibiotic prescriptions.
Antibiotic-related AEs and re-consultations for actual versus appropriate prescribing totalled £302,496,486 versus £63,854,269.
ARI prescribing plus AE costs totalled £326,729,943 annually without the use of delayed prescribing practices or POCT while the addition of delayed prescribing plus POCT totalled £60,114,564-£78,148,933 depending on the POCT.
As well as generating substantial cost savings, near patient diagnostic testing can benefit health systems and patients by avoiding exposure to unnecessary drugs, side effects and antibiotic-resistant pathogens, the study concluded.