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Use of clinical algorithms and rapid influenza testing to manage influenza-like illness: a cost-effectiveness analysis in Sri Lanka
- Source :
- BMJ Global Health
- Publication Year :
- 2019
- Publisher :
- BMJ, 2019.
-
Abstract
- BackgroundAcute 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.MethodsWe 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.ResultsStandard 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 ConclusionClinical prediction tools and targeted rapid influenza testing may be cost-saving strategies in Sri Lanka when accounting for the societal cost of antimicrobial resistance.
- Subjects :
- Marginal cost
medicine.medical_specialty
medicine.drug_class
030231 tropical medicine
Antibiotics
diagnostics and tools
03 medical and health sciences
0302 clinical medicine
Antibiotic resistance
medicine
health economics
030212 general & internal medicine
Medical prescription
Intensive care medicine
health care economics and organizations
Influenza-like illness
Health economics
business.industry
Research
Health Policy
Public Health, Environmental and Occupational Health
Cost-effectiveness analysis
3. Good health
Sri lanka
business
Subjects
Details
- ISSN :
- 20597908
- Volume :
- 4
- Database :
- OpenAIRE
- Journal :
- BMJ Global Health
- Accession number :
- edsair.doi.dedup.....50c50290373024e71afc178c4832df85