COST-EFFECTIVENESS ANALYSIS OF A RAPID MULTIPLEX PCR TEST FOR SEPSIS AND ANTIMICROBIAL RESISTANCE MANAGEMENT IN ICU PATIENTS
Author(s)
Georgi Svetoslavov Slavchev, PhD1, Adriana Dacheva, MA, PhD1, Hristo Krastev, MA1, Anita Hristova, MA1, Marta Encheva-Malinova, PhD1, Aleksandra Grozdanova, PhD2, Evgenija Mihajloska, PhD2, Slaveyko Djambazov, MBA, PhD1.
1HTA Ltd, Sofia, Bulgaria, 2Faculty of Pharmacy, University of Ss. Cyril and Methodius of Skopje, Skopje, North Macedonia, The Republic of.
1HTA Ltd, Sofia, Bulgaria, 2Faculty of Pharmacy, University of Ss. Cyril and Methodius of Skopje, Skopje, North Macedonia, The Republic of.
OBJECTIVES: Sepsis is associated with substantial clinical and economic burden in intensive care units, where delayed pathogen and antimicrobial resistance identification may prolong empirical treatment, increase mortality, and drive resource use. This study aimed to assess the cost-effectiveness of a rapid multiplex PCR test for identifying bloodstream infection, sepsis-related pathogens, and antimicrobial resistance in ICU patients compared with conventional microbiological culture in North Macedonia.
METHODS: A short-term cost-effectiveness model reflected an in-hospital episode of care in ICU patients with sepsis. The analysis was conducted from a combined hospital and public payer perspective. Conventional microbiological culture was the standard-of-care comparator. The model captured the impact of earlier pathogen and resistance identification on treatment optimization, empirical antimicrobial therapy, length of stay, ICU-related events, mortality, and direct medical costs. Clinical benefit was expressed as avoided deaths. Deterministic and probabilistic sensitivity analyses assessed uncertainty.
RESULTS: The multiplex PCR test was associated with lower total costs and improved clinical outcomes versus conventional microbiological culture. The estimated total cost per patient was MKD 76,696.34 with multiplex PCR testing versus MKD 91,601.11 with standard of care, resulting in savings of MKD 14,904.77 per patient. Mortality decreased from 11.7% to 7.9%, corresponding to 0.038 avoided deaths per patient. Mean length of stay decreased from 11.6 to 10.1 days, and empirical broad-spectrum antimicrobial treatment duration decreased from 3.75 to 2.50 days. Overall, multiplex PCR testing was dominant. Probabilistic sensitivity analysis showed a 97.2% probability of cost-effectiveness at the predefined willingness-to-pay threshold.
CONCLUSIONS: In ICU patients with sepsis, multiplex PCR testing was estimated to be a dominant diagnostic strategy compared with conventional microbiological culture. By enabling earlier identification of bloodstream pathogens and antimicrobial resistance, it may support treatment optimization, reduce hospital resource use, and improve sepsis management.
METHODS: A short-term cost-effectiveness model reflected an in-hospital episode of care in ICU patients with sepsis. The analysis was conducted from a combined hospital and public payer perspective. Conventional microbiological culture was the standard-of-care comparator. The model captured the impact of earlier pathogen and resistance identification on treatment optimization, empirical antimicrobial therapy, length of stay, ICU-related events, mortality, and direct medical costs. Clinical benefit was expressed as avoided deaths. Deterministic and probabilistic sensitivity analyses assessed uncertainty.
RESULTS: The multiplex PCR test was associated with lower total costs and improved clinical outcomes versus conventional microbiological culture. The estimated total cost per patient was MKD 76,696.34 with multiplex PCR testing versus MKD 91,601.11 with standard of care, resulting in savings of MKD 14,904.77 per patient. Mortality decreased from 11.7% to 7.9%, corresponding to 0.038 avoided deaths per patient. Mean length of stay decreased from 11.6 to 10.1 days, and empirical broad-spectrum antimicrobial treatment duration decreased from 3.75 to 2.50 days. Overall, multiplex PCR testing was dominant. Probabilistic sensitivity analysis showed a 97.2% probability of cost-effectiveness at the predefined willingness-to-pay threshold.
CONCLUSIONS: In ICU patients with sepsis, multiplex PCR testing was estimated to be a dominant diagnostic strategy compared with conventional microbiological culture. By enabling earlier identification of bloodstream pathogens and antimicrobial resistance, it may support treatment optimization, reduce hospital resource use, and improve sepsis management.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE39
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Medical Technologies
Disease
Infectious Disease (non-vaccine), No Additional Disease & Conditions/Specialized Treatment Areas