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Published in: Infection 6/2019

01-12-2019 | Meningitis | Original Paper

Economic analysis of rapid multiplex polymerase chain reaction testing for meningitis/encephalitis in adult patients

Authors: Steve Duff, Rodrigo Hasbun, Joan-Miquel Balada-Llasat, Louise Zimmer, Samuel. A. Bozzette, Christine C. Ginocchio

Published in: Infection | Issue 6/2019

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Abstract

Purpose

Many patients with suspected meningitis do not require hospitalization yet are admitted, often resulting in unnecessary care and additional cost. We assessed the possible economic impact of a rapid multiplex test for suspected adult community-acquired meningitis/encephalitis.

Methods

A model simulated diagnosis, clinical decisions, resource use/costs of standard of care (SOC) and two cerebrospinal fluid (CSF) testing strategies using the FDA-cleared BioFire® FilmArray® System (FA) which provides results in approximately one hour.

Results

Pathogens detected by FA caused approximately 74% of cases, 97% of which would be accurately diagnosed with FA. False positives and false negatives more often led to extended/unnecessary admission than inappropriate discharge/missed admission. Mean cost per case ranged from 16829 to 20791. A strategy of testing all suspected cases yielded greater savings (2213/case) than testing only those with abnormal CSF (812/case) and both were less expensive than SOC.

Conclusion

This economic analysis demonstrates that FA can inform more appropriate clinician decisions resulting in cost savings with greater economic benefits achievable with syndromic testing of all cases, rather than SOC or targeted syndromic testing.
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Metadata
Title
Economic analysis of rapid multiplex polymerase chain reaction testing for meningitis/encephalitis in adult patients
Authors
Steve Duff
Rodrigo Hasbun
Joan-Miquel Balada-Llasat
Louise Zimmer
Samuel. A. Bozzette
Christine C. Ginocchio
Publication date
01-12-2019
Publisher
Springer Berlin Heidelberg
Published in
Infection / Issue 6/2019
Print ISSN: 0300-8126
Electronic ISSN: 1439-0973
DOI
https://doi.org/10.1007/s15010-019-01320-7

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