Abstract
Background: Seasonal influenza causes significant morbidity worldwide and has a substantial economic impact on the healthcare system. Objective: To assess the cost–benefit relation of implementing a real-time influenza test in emergency rooms (ER) of German hospitals. Methods: A deterministic decision-analytic model was developed simulating the incremental costs of using the Solana® Influenza A+B test, compared to those of using conventional clinical judgement alone to confirm or exclude influenza in adult ILI (influenza-like illness) patients, in German ER, prior to hospitalization. Direct costs were evaluated from the hospital perspective, considering resource use directly related to influenza testing and treatment, as well as indirect costs incurred by nosocomial influenza transmission. Results: Through base-case analysis and assuming an influenza prevalence of 42.6%, real-time testing with Solana® reduced average costs of hospitalized ILI patients by €132.61, per tested patient. Moreover, the Solana® saved €6.9 per tested patient in favor of the hospital. In probabilistic sensitivity analysis, under all reasonable assumptions, implementing the Solana® saved on average €144.13 as compared to applying the clinical-judgement-only strategy, thus, it was found to be constantly less expensive. Conclusions: Using highly sensitive and specific real-time influenza tests in ILI patients at German ER might significantly reduce hospital expenditures
Highlights
Seasonal influenza remains a worldwide, annually recurring public health challenge
As all inpatients with influenza have to be kept in costly respiratory isolation until it can be assumed that they are no longer contagious, a correct classification of the influenza-like illness (ILI) as being truly caused by the influenza virus, rather than other viruses, e.g., parainfluenza virus, respiratory syncytial virus (RSV), or adenoviruses, helps to a great extent before making the expensive decision to isolate
The Solana® algorithm was used, in which all ILI patients coming to the emergency rooms (ER) of a hospital during a seasonal influenza pandemic are tested with the Solana®, after using a nasopharyngeal swab
Summary
In Germany, in the 2017/2018 season there were 334,000 confirmed influenza patients (nearly 400/100,000) [1] and the prevalence among influenza-like illness (ILI) patients was 42.6% [2]. Eighteen percent (18%) of those patients—with no difference between the proportion of ILI patients and patients with laboratory confirmed influenza—had to be hospitalized, imposing a high economic burden to the statutory public health insurances (PHI) [3]. A deterministic decision-analytic model was developed simulating the incremental costs of using the Solana® Influenza A+B test, compared to those of using conventional clinical judgement alone to confirm or exclude influenza in adult ILI (influenza-like illness) patients, in German ER, prior to hospitalization. Results: Through base-case analysis and assuming an influenza prevalence of 42.6%, real-time testing with Solana® reduced average costs of hospitalized ILI patients by €132.61, per tested patient. The Solana® saved €6.9 per tested patient in favor of the hospital
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