Use of clinical algorithms and rapid influenza testing to manage influenza-like illness: a cost-effectiveness analysis in Sri Lanka.

Published

Journal Article

Background:Acute respiratory infections are a common reason for antibiotic overuse. We previously showed that providing Sri Lankan clinicians with positive rapid influenza test results was associated with a reduction in antibiotic prescriptions. The economic impact of influenza diagnostic strategies is unknown. Methods:We estimated the incremental cost per antibiotic prescription avoided with three diagnostic strategies versus standard care when managing Sri Lankan outpatients with influenza-like illness (ILI): (1) influenza clinical prediction tool, (2) targeted rapid influenza testing and (3) universal rapid influenza testing. We compared findings with literature-based estimates of the cost of antimicrobial resistance attributable to each antibiotic prescription. Results:Standard care was less expensive than other strategies across all parameter values in one-way sensitivity analyses. The incremental cost per antibiotic prescription avoided with clinical prediction versus standard care was US$3.0, which was lower than the base-case estimate of the cost of antimicrobial resistance per ILI antibiotic prescription (US$12.5). The incremental cost per antibiotic prescription avoided with targeted testing and universal testing versus standard care were both higher than the base-case cost of antimicrobial resistance per ILI antibiotic prescription: US$49.1 and US$138.3, respectively. To obtain a cost-effectiveness ratio lower than US$12.5 with targeted testing versus standard care, the test price must be

Full Text

Duke Authors

Cited Authors

  • Tillekeratne, LG; Bodinayake, C; Nagahawatte, A; Kurukulasooriya, R; Orlando, LA; Simmons, RA; Park, LP; Woods, CW; Reed, SD

Published Date

  • January 2019

Published In

Volume / Issue

  • 4 / 2

Start / End Page

  • e001291 -

PubMed ID

  • 30997171

Pubmed Central ID

  • 30997171

Electronic International Standard Serial Number (EISSN)

  • 2059-7908

International Standard Serial Number (ISSN)

  • 2059-7908

Digital Object Identifier (DOI)

  • 10.1136/bmjgh-2018-001291

Language

  • eng