Aim: Screening and monitoring of diabetes or dyslipidemia frequently involves a multi-step process requiring patients to obtain test requisitions from their primary care physician (PCP), followed by a laboratory visit and re-consultation. Point-of-care testing (POCT) for hemoglobin A1c (HbA1c) and lipid panel can streamline the patient care pathway. This study assessed the budget impact of introducing Afinion™ 2 POCT (Abbott Rapid Diagnostics) from the Canadian and Italian societal perspectives. Methods: Budget impact models were developed for Canada and Italy over a 5-year time horizon (2025 to 2029). The analyses considered the screening and monitoring of diabetes or dyslipidemia for patients utilizing the public healthcare system and attending primary care, and included direct costs (testing, consultations) and indirect costs (productivity loss, transportation) based on published sources. The budget impact (BI) was calculated by comparing scenarios with and without POCT. All costs were adjusted to Canadian dollars ($) or 2024 Euros (€). Scenario analyses were conducted to explore the impact of alternative assumptions. Results: The 5-year cumulative BI was -$758,006,692 (-$50,709,964 direct, -$707,296,728 indirect) for HbA1c POCT and -$726,452,755 ($2,684,011 direct, -$729,136,766 indirect) for lipid panel POCT in Canada and -€1,380,658,764 (-€6,391,954 direct, -€1,374,266,809 indirect) for HbA1c POCT and -€851,792,115 (€55,962,879 direct, -€907,754,993 indirect) for lipid panel POCT in Italy. In both countries, cost savings for both the healthcare payer and patients were observed for HbA1c POCT, while costs savings were derived from patient indirect costs for lipid panel POCT. The analyses estimated that 1,558,062 and 1,501,260 PCP consultations in Canada, 4,962,338 and 1,951,026 PCP consultations in Italy were avoided with implementation of POCT for HbA1c and lipid panel, respectively. Scenario analyses demonstrated potential further cost savings with implementation of POCT in pharmacies. Conclusion: This study demonstrates that the adoption of Afinion 2 POCT for HbA1c and lipid panel can provide efficiencies to different types of healthcare systems through reducing PCP consultations, saving time and money for patients and providing cost savings for payers.
Keywords: Canada; HbA1c; Italy; budget impact model; diabetes; dyslipidemia; lipid panel.
What was the aim of this research? To compare the costs and change in number of primary care visits associated with the use of Afinion™ 2 point-of-care testing (POCT) for screening and monitoring of diabetes and dyslipidemia versus traditional laboratory testing for Canadian and Italian healthcare systems. How was the research carried out? A budget impact model was developed to compare costs between traditional laboratory testing pathways and Afinion 2 POCT over 5 years for Canada and Italy. Screening and monitoring of diabetes or dyslipidemia for patients utilizing the public healthcare system and attending primary care visits were analyzed. Direct (testing, physician visits) and indirect costs (productivity loss, transportation) were also included. What were the results? Utilization of Afinion 2 POCT can reduce the number of primary care and laboratory visits for patients with diabetes or dyslipidemia, resulting in decreased healthcare resource utilization and increased efficiency for both healthcare providers and patients. The overall budget impact was cost-saving for both HbA1c and lipid panel testing in Canada and Italy, with the main cost drivers being attributed to indirect cost savings and a reduction in primary care visits. What do the results of the study mean? Implementing Afinion 2 POCT for diabetes and lipid panel testing can make the Canadian and Italian healthcare systems more streamlined by reducing the number of primary care visits for disease management, saving money and time for patients and providing cost savings for payers.