COST-EFFECTIVENESS OF PROCALCITONIN-GUIDED ANTIBIOTIC THERAPY IN ADULT PATIENTS WITH ACUTE RESPIRATORY INFECTION IN A COLOMBIAN REFERRAL HOSPITAL
Author(s)
Jorge Medina, MsC1, Díaz Rojas Jorge A., PhD2;
1National University Colombia, Student, BOGOTA, Colombia, 2Universidad Nacional de Colombia, Professor, Bogotá, Colombia
1National University Colombia, Student, BOGOTA, Colombia, 2Universidad Nacional de Colombia, Professor, Bogotá, Colombia
OBJECTIVES: To assess the cost-effectiveness of procalcitonin-guided antibiotic therapy compared with standard management in adult patients hospitalized with acute respiratory infection (ARI) in a tertiary referral hospital in Colombia.
METHODS: A full economic evaluation was conducted from the hospital perspective for the year 2023. Effectiveness inputs were obtained through a systematic review of the literature. Costs were estimated using a case-type costing approach based on national clinical practice guidelines, institutional databases, and expert consultation, including hospitalization, pharmacological treatment, laboratory tests, procedures, and antibiotic-related adverse events. A decision tree model was developed to compare procalcitonin-guided therapy versus standard care over an acute time horizon corresponding to the hospitalization episode. The primary effectiveness outcome was prevention of antibiotic-related adverse events. Deterministic (one-way) and probabilistic sensitivity analyses using Monte Carlo simulation (1,000 iterations) were performed to assess parameter uncertainty
RESULTS: Procalcitonin-guided antibiotic therapy demonstrated moderate-to-high quality evidence in reducing antibiotic exposure and antibiotic-related adverse events. In the base-case analysis, the procalcitonin strategy was associated with higher costs (incremental cost: USD $99.44) and greater effectiveness (incremental effectiveness: 0.06 adverse events avoided) compared with standard management. The intervention showed a more favorable clinical profile in patients managed in general hospitalization, while greater uncertainty was observed in cost-related parameters. Probabilistic sensitivity analysis indicated an intermediate probability of cost-effectiveness, particularly in less conservative willingness-to-pay scenarios for preventing antibiotic-related adverse events.
CONCLUSIONS: In this Colombian hospital-based setting, procalcitonin-guided antibiotic therapy showed an intermediate likelihood of being cost-effective compared with standard care for adult patients with acute respiratory infection. Its value appears to be optimized when applied selectively rather than universally. These findings support personalized implementation strategies and highlight the importance of antimicrobial stewardship tools in resource-constrained health systems.
METHODS: A full economic evaluation was conducted from the hospital perspective for the year 2023. Effectiveness inputs were obtained through a systematic review of the literature. Costs were estimated using a case-type costing approach based on national clinical practice guidelines, institutional databases, and expert consultation, including hospitalization, pharmacological treatment, laboratory tests, procedures, and antibiotic-related adverse events. A decision tree model was developed to compare procalcitonin-guided therapy versus standard care over an acute time horizon corresponding to the hospitalization episode. The primary effectiveness outcome was prevention of antibiotic-related adverse events. Deterministic (one-way) and probabilistic sensitivity analyses using Monte Carlo simulation (1,000 iterations) were performed to assess parameter uncertainty
RESULTS: Procalcitonin-guided antibiotic therapy demonstrated moderate-to-high quality evidence in reducing antibiotic exposure and antibiotic-related adverse events. In the base-case analysis, the procalcitonin strategy was associated with higher costs (incremental cost: USD $99.44) and greater effectiveness (incremental effectiveness: 0.06 adverse events avoided) compared with standard management. The intervention showed a more favorable clinical profile in patients managed in general hospitalization, while greater uncertainty was observed in cost-related parameters. Probabilistic sensitivity analysis indicated an intermediate probability of cost-effectiveness, particularly in less conservative willingness-to-pay scenarios for preventing antibiotic-related adverse events.
CONCLUSIONS: In this Colombian hospital-based setting, procalcitonin-guided antibiotic therapy showed an intermediate likelihood of being cost-effective compared with standard care for adult patients with acute respiratory infection. Its value appears to be optimized when applied selectively rather than universally. These findings support personalized implementation strategies and highlight the importance of antimicrobial stewardship tools in resource-constrained health systems.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE442
Topic
Economic Evaluation
Disease
SDC: Infectious Disease (non-vaccine), SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)