Cost Impact Model of a Novel Multi-mRNA Host Response Assay for Diagnosis and Risk Assessment of Acute Respiratory Tract Infections and Sepsis in the Emergency Department
**Background:** Early identification of acute infections and sepsis remains an unmet medical need. While early detection and initiation of treatment reduces mortality, inappropriate treatment leads to adverse events and the development of antimicrobial resistance. Current diagnostic and prognostic s...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Columbia Data Analytics, LLC
2020-04-01
|
| Series: | Journal of Health Economics and Outcomes Research |
| Online Access: | https://doi.org/10.36469/jheor.2020.12637 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1823860304649388032 |
|---|---|
| author | John E. Schneider Jonathan Romanowsky Philipp Schuetz Ivana Stojanovic Henry K. Cheng Oliver Liesenfeld Ljubomir Buturovic Timothy E. Sweeney |
| author_facet | John E. Schneider Jonathan Romanowsky Philipp Schuetz Ivana Stojanovic Henry K. Cheng Oliver Liesenfeld Ljubomir Buturovic Timothy E. Sweeney |
| author_sort | John E. Schneider |
| collection | DOAJ |
| description | **Background:** Early identification of acute infections and sepsis remains an unmet medical need. While early detection and initiation of treatment reduces mortality, inappropriate treatment leads to adverse events and the development of antimicrobial resistance. Current diagnostic and prognostic solutions, including procalcitonin, lack required accuracy. A novel blood-based host response test, HostDx™ Sepsis by Inflammatix, Inc., assesses the likelihood of a bacterial infection, the likelihood of a viral infection, and the severity of the condition.
**Objectives:** We estimated the economic impact of adopting HostDx Sepsis testing among patients with suspected acute respiratory tract infection (ARTI) in the emergency department (ED).
**Methods:** Our cost impact model estimated costs for adult ED patients with suspected ARTI under the standard of care versus with the adoption of HostDx Sepsis from the perspective of US payers. Included costs were those assumed to be associated with an episode of sepsis diagnosis, management, and treatment. Projected accuracies for test predictions, disease prevalence, and clinical parameters was derived from patient-level meta-analysis data of randomized trials, supplemented with published performance data for HostDx Sepsis. One-way sensitivity analysis was performed on key input parameters.
**Results:** Compared to standard of care including procalcitonin, the superior test characteristics of HostDx Sepsis resulted in an average cost savings of approximately US$1974 per patient (-31.3%) exclusive of the cost of HostDx Sepsis. Reductions in hospital days (-0.80 days, -36.7%), antibiotic days (-1.49 days, -29.5%), and percent 30-day mortality (-1.67%, -13.64%) were driven by HostDx Sepsis providing fewer “noninformative” moderate risk predictions and more “certain” low- or high-risk predictions compared to standard of care, especially for patients who were not severely ill. These results were robust to changes in key parameters, including disease prevalence.
**Conclusions:** Our model shows substantial savings associated with introduction of HostDx Sepsis among patients with ARTIs in EDs. These results need confirmation in interventional trials. |
| format | Article |
| id | doaj-art-b45f856a3f1048fdba9e5b3cd72cddac |
| institution | Kabale University |
| issn | 2327-2236 |
| language | English |
| publishDate | 2020-04-01 |
| publisher | Columbia Data Analytics, LLC |
| record_format | Article |
| series | Journal of Health Economics and Outcomes Research |
| spelling | doaj-art-b45f856a3f1048fdba9e5b3cd72cddac2025-02-10T16:13:16ZengColumbia Data Analytics, LLCJournal of Health Economics and Outcomes Research2327-22362020-04-0171Cost Impact Model of a Novel Multi-mRNA Host Response Assay for Diagnosis and Risk Assessment of Acute Respiratory Tract Infections and Sepsis in the Emergency DepartmentJohn E. SchneiderJonathan RomanowskyPhilipp SchuetzIvana StojanovicHenry K. ChengOliver LiesenfeldLjubomir ButurovicTimothy E. Sweeney**Background:** Early identification of acute infections and sepsis remains an unmet medical need. While early detection and initiation of treatment reduces mortality, inappropriate treatment leads to adverse events and the development of antimicrobial resistance. Current diagnostic and prognostic solutions, including procalcitonin, lack required accuracy. A novel blood-based host response test, HostDx™ Sepsis by Inflammatix, Inc., assesses the likelihood of a bacterial infection, the likelihood of a viral infection, and the severity of the condition. **Objectives:** We estimated the economic impact of adopting HostDx Sepsis testing among patients with suspected acute respiratory tract infection (ARTI) in the emergency department (ED). **Methods:** Our cost impact model estimated costs for adult ED patients with suspected ARTI under the standard of care versus with the adoption of HostDx Sepsis from the perspective of US payers. Included costs were those assumed to be associated with an episode of sepsis diagnosis, management, and treatment. Projected accuracies for test predictions, disease prevalence, and clinical parameters was derived from patient-level meta-analysis data of randomized trials, supplemented with published performance data for HostDx Sepsis. One-way sensitivity analysis was performed on key input parameters. **Results:** Compared to standard of care including procalcitonin, the superior test characteristics of HostDx Sepsis resulted in an average cost savings of approximately US$1974 per patient (-31.3%) exclusive of the cost of HostDx Sepsis. Reductions in hospital days (-0.80 days, -36.7%), antibiotic days (-1.49 days, -29.5%), and percent 30-day mortality (-1.67%, -13.64%) were driven by HostDx Sepsis providing fewer “noninformative” moderate risk predictions and more “certain” low- or high-risk predictions compared to standard of care, especially for patients who were not severely ill. These results were robust to changes in key parameters, including disease prevalence. **Conclusions:** Our model shows substantial savings associated with introduction of HostDx Sepsis among patients with ARTIs in EDs. These results need confirmation in interventional trials.https://doi.org/10.36469/jheor.2020.12637 |
| spellingShingle | John E. Schneider Jonathan Romanowsky Philipp Schuetz Ivana Stojanovic Henry K. Cheng Oliver Liesenfeld Ljubomir Buturovic Timothy E. Sweeney Cost Impact Model of a Novel Multi-mRNA Host Response Assay for Diagnosis and Risk Assessment of Acute Respiratory Tract Infections and Sepsis in the Emergency Department Journal of Health Economics and Outcomes Research |
| title | Cost Impact Model of a Novel Multi-mRNA Host Response Assay for Diagnosis and Risk Assessment of Acute Respiratory Tract Infections and Sepsis in the Emergency Department |
| title_full | Cost Impact Model of a Novel Multi-mRNA Host Response Assay for Diagnosis and Risk Assessment of Acute Respiratory Tract Infections and Sepsis in the Emergency Department |
| title_fullStr | Cost Impact Model of a Novel Multi-mRNA Host Response Assay for Diagnosis and Risk Assessment of Acute Respiratory Tract Infections and Sepsis in the Emergency Department |
| title_full_unstemmed | Cost Impact Model of a Novel Multi-mRNA Host Response Assay for Diagnosis and Risk Assessment of Acute Respiratory Tract Infections and Sepsis in the Emergency Department |
| title_short | Cost Impact Model of a Novel Multi-mRNA Host Response Assay for Diagnosis and Risk Assessment of Acute Respiratory Tract Infections and Sepsis in the Emergency Department |
| title_sort | cost impact model of a novel multi mrna host response assay for diagnosis and risk assessment of acute respiratory tract infections and sepsis in the emergency department |
| url | https://doi.org/10.36469/jheor.2020.12637 |
| work_keys_str_mv | AT johneschneider costimpactmodelofanovelmultimrnahostresponseassayfordiagnosisandriskassessmentofacuterespiratorytractinfectionsandsepsisintheemergencydepartment AT jonathanromanowsky costimpactmodelofanovelmultimrnahostresponseassayfordiagnosisandriskassessmentofacuterespiratorytractinfectionsandsepsisintheemergencydepartment AT philippschuetz costimpactmodelofanovelmultimrnahostresponseassayfordiagnosisandriskassessmentofacuterespiratorytractinfectionsandsepsisintheemergencydepartment AT ivanastojanovic costimpactmodelofanovelmultimrnahostresponseassayfordiagnosisandriskassessmentofacuterespiratorytractinfectionsandsepsisintheemergencydepartment AT henrykcheng costimpactmodelofanovelmultimrnahostresponseassayfordiagnosisandriskassessmentofacuterespiratorytractinfectionsandsepsisintheemergencydepartment AT oliverliesenfeld costimpactmodelofanovelmultimrnahostresponseassayfordiagnosisandriskassessmentofacuterespiratorytractinfectionsandsepsisintheemergencydepartment AT ljubomirbuturovic costimpactmodelofanovelmultimrnahostresponseassayfordiagnosisandriskassessmentofacuterespiratorytractinfectionsandsepsisintheemergencydepartment AT timothyesweeney costimpactmodelofanovelmultimrnahostresponseassayfordiagnosisandriskassessmentofacuterespiratorytractinfectionsandsepsisintheemergencydepartment |