Point-of-care multiplex PCR reduces isolation costs for non-infected HCID suspects in economic model
Investigators developed a decision-analytic model comparing a point-of-care multiplex PCR panel plus standard diagnostics against standard diagnostics alone for suspected high-consequence infectious diseases. The analysis found that while the multiplex approach increased costs by approximately €406 per truly infected patient, it reduced costs by roughly €2,009 per non-infected suspect by shortening unnecessary high-level isolation periods. Probabilistic sensitivity analysis confirmed these trends, with isolation costs and assay sensitivity identified as the primary economic drivers. For laboratory directors and hospital administrators, the findings suggest that deploying rapid multiplex testing in HCID triage workflows can yield net cost savings in settings where true infection prevalence is low, though local isolation expenses and testing sensitivity will dictate overall economic impact.
The original study
Cost effects of using point-of-care multiplex PCR for high consequence infectious diseases suspect cases.
- Authors
- Metz S, Golbach R, Borgans F, Vehreschild MJGT, Wolf T
- Journal
- Infection
- Type
- Journal Article
- PMID
- 42601585
Original abstract
INTRODUCTION: High-consequence infectious diseases (HCID) are rare in Europe but require rapid evaluation due to the risk of transmission. Suspected cases often involve resource-intensive high-level isolation. Point-of-care multiplex PCR may shorten unnecessary isolation by enabling faster rule-out. METHODS: We developed a decision-analytic model comparing the BioFire® FilmArray® Global Fever Panel (RUO) plus standard diagnostics (strategy 1) versus standard diagnostics alone (strategy 2). Costs were assessed from the hospital perspective from blood sampling to the standard diagnostic result, plus contact isolation after unprotected exposure following false-negative multiplex results. Two scenarios were analysed separately: the patient is HCID infected vs. not infected. We performed a base case deterministic analysis using the baseline parameter values and a probabilistic sensitivity analysis (PSA; 10,000 simulations). RESULTS: In the base case deterministic analysis, strategy 1 increased costs by € 406.35 per infected patient and reduced costs by € 2,009.31 per non-infected patient compared to strategy 2. Concerning the PSA, strategy 1 remained more costly for infected patients (mean Δinf € 408.75; range € 207.4 - € 1,083.9) and cost-saving for non-infected patients (mean Δnot € 2,098.40; range € 1,097.0 - € 3,371.9). Key drivers were multiplex sensitivity (infected scenario) and isolation costs during standard diagnostics and the multiplex pcr (non-infected scenario). CONCLUSION: Multiplex PCR increased costs in true HCID cases but reduced costs in non-infected suspects by shortening isolation. Given the very low frequency of true HCID among suspected cases in Europe, overall cost savings appear plausible, depending on local workflows and isolation costs.