Humphries Brittany, Sun Yuan, Pernica Jeffrey, Xie Feng
Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Department of Pediatrics, McMaster University, Hamilton, ON, Canada.
BMC Infect Dis. 2025 Mar 3;25(1):305. doi: 10.1186/s12879-025-10608-z.
Antibiotics are broadly prescribed for community-acquired pneumonia (CAP) despite being only effective for bacterial infections. LIAISON MeMed BV (LMMBV) is a novel diagnostic test that can support clinicians in differentiating bacterial from viral infections and guide diagnostic-driven antibiotic prescribing.
We developed a cost-impact model to compare the clinical and economic outcomes of using LMMBV with the current standard of care (SOC) versus SOC alone among a hypothetical cohort of 1,000 CAP patients presenting to the emergency department. The analysis was conducted from a Canadian public health payer's perspective. Outcomes of interest included antibiotic use (number of patients and days saved), hospital admission (admissions avoided and days saved), intensive care unit admission, adverse events, and clostridium difficile infection. One-way sensitivity analyses were conducted to explore parameter uncertainty. Scenario analyses were conducted according to age group, province, and impact of LMMBV on hospitalization.
In the base case, LMMBV plus SOC reduced the number of patients prescribed antibiotic treatment (429 patients avoided) and the total number of antibiotic treatment days (1,020 days avoided). The per-patient cost savings were $504.96 compared to SOC alone. These findings were consistent across all sensitivity and scenario analyses. Assuming full adoption of LMMBV, the per patient cost savings are projected to result in more than $163 million in total savings annually in Canada based on population estimates and published incidence data.
Considering the burden of CAP and antimicrobial resistance to the health care system, the use of LMMBV with SOC can offer both clinical and economic benefits to Canadian public payers.
尽管抗生素仅对细菌感染有效，但在社区获得性肺炎（CAP）的治疗中仍被广泛使用。LIAISON MeMed BV（LMMBV）是一种新型诊断测试，可帮助临床医生区分细菌感染和病毒感染，并指导基于诊断的抗生素处方。
我们开发了一个成本影响模型，以比较在假设的1000名到急诊科就诊的CAP患者队列中，使用LMMBV联合当前标准治疗（SOC）与仅使用SOC的临床和经济结果。该分析是从加拿大公共卫生支付方的角度进行的。感兴趣的结果包括抗生素使用情况（节省的患者数量和天数）、住院情况（避免的住院次数和天数）、重症监护病房入住情况、不良事件以及艰难梭菌感染。进行了单向敏感性分析以探索参数的不确定性。根据年龄组、省份以及LMMBV对住院的影响进行了情景分析。
在基础案例中，LMMBV联合SOC减少了接受抗生素治疗的患者数量（避免了429名患者）以及抗生素治疗的总天数（避免了1020天）。与仅使用SOC相比，每位患者节省的成本为504.96美元。这些发现在所有敏感性和情景分析中都是一致的。假设全面采用LMMBV，根据人口估计和已公布的发病率数据，预计在加拿大每年每位患者节省的成本将总共节省超过1.63亿美元。
考虑到CAP的负担以及对抗菌药物耐药性对医疗保健系统的影响，将LMMBV与SOC联合使用可为加拿大公共支付方带来临床和经济效益。
