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Infection

pp 1–9 | Cite as

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

  • Steve DuffEmail author
  • Rodrigo Hasbun
  • Joan-Miquel Balada-Llasat
  • Louise Zimmer
  • Samuel. A. Bozzette
  • Christine C. Ginocchio
Original Paper

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.

Keywords

Cost Encephalitis FilmArray Meningitis 

Notes

Funding

Research funding for this project was provided by bioMérieux.

Compliance with ethical standards

Conflict of interest

SD is a paid consultant to bioMérieux and an employee of Veritas Health Economics Consulting; RH and JMBL are consultants to bioMérieux and speakers for BioFire Diagnostics; CCG is an employee of bioMérieux and BioFire Diagnostics and owns bioMérieux stock; LZ is an employee of bioMérieux; SAB was an employee of bioMérieux at the time the research was conducted.

Supplementary material

15010_2019_1320_MOESM1_ESM.docx (118 kb)
Supplementary material 1 (DOCX 118 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Steve Duff
    • 1
    Email author
  • Rodrigo Hasbun
    • 2
  • Joan-Miquel Balada-Llasat
    • 3
  • Louise Zimmer
    • 4
  • Samuel. A. Bozzette
    • 4
    • 5
  • Christine C. Ginocchio
    • 4
    • 6
  1. 1.Veritas Health Economics ConsultingCarlsbadUSA
  2. 2.UTHealth McGovern Medical SchoolHoustonUSA
  3. 3.The Ohio State University Wexner Medical CenterColumbusUSA
  4. 4.bioMérieuxDurhamUSA
  5. 5.University of California, San DiegoLa JollaUSA
  6. 6.Zucker School of Medicine at Hofstra NorthwellHempsteadUSA

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