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Economic Analyses of Respiratory Tract Infection Diagnostics: A Systematic Review


  • Simon van der Pol

    (University of Groningen, University Medical Center Groningen
    UMCG, Sector F, afdeling Gezondheidswetenschappen)

  • Paula Rojas Garcia

    (University of La Rioja)

  • Maarten J. Postma

    (University of Groningen, University Medical Center Groningen
    University of Groningen)

  • Fernando Antoñanzas Villar

    (University of La Rioja)

  • Antoinette D. I. Asselt

    (University of Groningen, University Medical Center Groningen
    University of Groningen, University Medical Center Groningen)


Background Diagnostic testing for respiratory tract infections is a tool to manage the current COVID-19 pandemic, as well as the rising incidence of antimicrobial resistance. At the same time, new European regulations for market entry of in vitro diagnostics, in the form of the in vitro diagnostic regulation, may lead to more clinical evidence supporting health-economic analyses. Objective The objective of this systematic review was to review the methods used in economic evaluations of applied diagnostic techniques, for all patients seeking care for infectious diseases of the respiratory tract (such as pneumonia, pulmonary tuberculosis, influenza, sinusitis, pharyngitis, sore throats and general respiratory tract infections). Methods Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, articles from three large databases of scientific literature were included (Scopus, Web of Science and PubMed) for the period January 2000 to May 2020. Results A total of 70 economic analyses are included, most of which use decision tree modelling for diagnostic testing for respiratory tract infections in the community-care setting. Many studies do not incorporate a generally comparable clinical outcome in their cost-effectiveness analysis: fewer than half the studies (33/70) used generalisable outcomes such as quality-adjusted life-years. Other papers consider outcomes related to the accuracy of the test or outcomes related to the prescribed treatment. The time horizons of the studies generally are limited. Conclusions The methods to economically assess diagnostic tests for respiratory tract infections vary and would benefit from clear recommendations from policy makers on the assessed time horizon and outcomes used.

Suggested Citation

  • Simon van der Pol & Paula Rojas Garcia & Maarten J. Postma & Fernando Antoñanzas Villar & Antoinette D. I. Asselt, 2021. "Economic Analyses of Respiratory Tract Infection Diagnostics: A Systematic Review," PharmacoEconomics, Springer, vol. 39(12), pages 1411-1427, December.
  • Handle: RePEc:spr:pharme:v:39:y:2021:i:12:d:10.1007_s40273-021-01054-1
    DOI: 10.1007/s40273-021-01054-1

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    References listed on IDEAS

    1. Janne C Mewes & Michael S Pulia & Michael K Mansour & Michael R Broyles & H Bryant Nguyen & Lotte M Steuten, 2019. "The cost impact of PCT-guided antibiotic stewardship versus usual care for hospitalised patients with suspected sepsis or lower respiratory tract infections in the US: A health economic model analysis," PLOS ONE, Public Library of Science, vol. 14(4), pages 1-16, April.
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    3. Nicolas A Menzies & Ted Cohen & Hsien-Ho Lin & Megan Murray & Joshua A Salomon, 2012. "Population Health Impact and Cost-Effectiveness of Tuberculosis Diagnosis with Xpert MTB/RIF: A Dynamic Simulation and Economic Evaluation," PLOS Medicine, Public Library of Science, vol. 9(11), pages 1-17, November.
    4. Kunling Shen & Tengbin Xiong & Seng Chuen Tan & Jiuhong Wu, 2016. "Oseltamivir Treatment for Children with Influenza-Like Illness in China: A Cost-Effectiveness Analysis," PLOS ONE, Public Library of Science, vol. 11(4), pages 1-13, April.
    5. Anna Vassall & Sanne van Kampen & Hojoon Sohn & Joy S Michael & K R John & Saskia den Boon & J Lucian Davis & Andrew Whitelaw & Mark P Nicol & Maria Tarcela Gler & Anar Khaliqov & Carlos Zamudio & Mar, 2011. "Rapid Diagnosis of Tuberculosis with the Xpert MTB/RIF Assay in High Burden Countries: A Cost-Effectiveness Analysis," PLOS Medicine, Public Library of Science, vol. 8(11), pages 1-14, November.
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    Cited by:

    1. Saad I. Nafisah & Ghulam Muhammad & M. Shamim Hossain & Salman A. AlQahtani, 2023. "A Comparative Evaluation between Convolutional Neural Networks and Vision Transformers for COVID-19 Detection," Mathematics, MDPI, vol. 11(6), pages 1-20, March.
    2. Simon Pol & Paula Rojas Garcia & Fernando Antoñanzas Villar & Maarten J. Postma & Antoinette D. I. Asselt, 2021. "Health-Economic Analyses of Diagnostics: Guidance on Design and Reporting," PharmacoEconomics, Springer, vol. 39(12), pages 1355-1363, December.

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