Economic Analyses of Respiratory Tract Infection Diagnostics: A Systematic Review

Simon van der Pol (), Paula Rojas Garcia, Maarten J. Postma, Fernando Antoñanzas Villar and Antoinette D. I. Asselt
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Simon van der Pol: University of Groningen, University Medical Center Groningen
Paula Rojas Garcia: University of La Rioja
Maarten J. Postma: University of Groningen, University Medical Center Groningen
Fernando Antoñanzas Villar: University of La Rioja
Antoinette D. I. Asselt: University of Groningen, University Medical Center Groningen

PharmacoEconomics, 2021, vol. 39, issue 12, No 6, 1427 pages

Abstract: Abstract Background Diagnostic testing for respiratory tract infections is a tool to manage the current COVID-19 pandemic, as well as the rising incidence of antimicrobial resistance. At the same time, new European regulations for market entry of in vitro diagnostics, in the form of the in vitro diagnostic regulation, may lead to more clinical evidence supporting health-economic analyses. Objective The objective of this systematic review was to review the methods used in economic evaluations of applied diagnostic techniques, for all patients seeking care for infectious diseases of the respiratory tract (such as pneumonia, pulmonary tuberculosis, influenza, sinusitis, pharyngitis, sore throats and general respiratory tract infections). Methods Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, articles from three large databases of scientific literature were included (Scopus, Web of Science and PubMed) for the period January 2000 to May 2020. Results A total of 70 economic analyses are included, most of which use decision tree modelling for diagnostic testing for respiratory tract infections in the community-care setting. Many studies do not incorporate a generally comparable clinical outcome in their cost-effectiveness analysis: fewer than half the studies (33/70) used generalisable outcomes such as quality-adjusted life-years. Other papers consider outcomes related to the accuracy of the test or outcomes related to the prescribed treatment. The time horizons of the studies generally are limited. Conclusions The methods to economically assess diagnostic tests for respiratory tract infections vary and would benefit from clear recommendations from policy makers on the assessed time horizon and outcomes used.

Date: 2021
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DOI: 10.1007/s40273-021-01054-1

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