Cost effectiveness of a point-of-care test for adenoviral conjunctivitis

Am J Med Sci. 2008 Sep;336(3):254-64. doi: 10.1097/MAJ.0b013e3181637417.

Abstract

Background: Conjunctivitis is a relatively common condition of the eye that can be caused by a number of different pathogens including bacteria and viruses. Clinical differentiation between adenoviral and bacterial conjunctivitis is difficult, often resulting in misdiagnosis and the provision of inappropriate treatment.

Methods: A cost-effectiveness analysis was performed from a societal perspective using primary, secondary, published literature, and expert opinion data sources. The incremental costs and effects (cases of unnecessary antibiotic treatment avoided) for a rapid point-of-care test for adenoviral conjunctivitis (RPS Adeno Detector) were modeled.

Results: Using base case values, the incremental cost of using no point-of-care test compared with the point-of-care test is $71.30 with 0.1786 cases of unnecessary antibiotic treatment. Extrapolating these costs to the entire U.S. population per annum, society could potentially save nearly $430 million currently spent on unnecessary medical care and avoid over 1 million cases of unnecessary antibiotic treatment. The no-point-of-care test strategy is both more costly and less effective; indicating that the point-of-care test strategy is the most cost-effective option. The results were robust to variation in key model parameters.

Conclusions: Through the use of a rapid point-of-care test for adenovirus, much of the cost to society caused by acute conjunctivitis can be avoided through more timely and accurate diagnosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenovirus Infections, Human / diagnosis*
  • Adenovirus Infections, Human / economics
  • Adenovirus Infections, Human / epidemiology
  • Computer Simulation
  • Conjunctivitis, Viral / diagnosis*
  • Conjunctivitis, Viral / economics
  • Conjunctivitis, Viral / epidemiology
  • Cost-Benefit Analysis
  • Diagnostic Errors / economics
  • Diagnostic Tests, Routine / economics*
  • Health Care Costs
  • Humans
  • Models, Econometric
  • Pharmaceutical Preparations / economics
  • Point-of-Care Systems*
  • Prevalence
  • Sensitivity and Specificity
  • United States / epidemiology

Substances

  • Pharmaceutical Preparations