COST-EFFECTIVENESS ANALYSIS OF RAPID MULTIPLEX PCR TESTING FOR PNEUMONIA MANAGEMENT
Author(s)
Anita Hristova, MA1, Adriana Dacheva, MA, PhD1, Georgi Svetoslavov Slavchev, PhD1, Hristo Krastev, 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: Pneumonia is associated with substantial clinical and economic burden among hospitalized patients; delayed pathogen identification may prolong empirical antimicrobial treatment, increase hospital length of stay, and drive hospital resource use. This study aimed to assess the cost-effectiveness of rapid multiplex PCR testing for the identification and semi-quantification of pneumonia-related pathogens and resistance markers compared with conventional microbiological culture in hospitalized patients with pneumonia in North Macedonia.
METHODS: A short-term cost-effectiveness model was developed to reflect an in-hospital episode of care in hospitalized patients with pneumonia. The analysis was conducted from a combined hospital and public payer perspective. Conventional microbiological culture was used as the standard-of-care comparator. The model captured the impact of earlier diagnostic results on treatment optimization, antimicrobial duration, hospital length of stay, and direct medical costs. Inputs were informed by published clinical evidence, local cost data, and real-world hospital information reflecting routine pneumonia management. Outcomes included total cost per patient, hospital days avoided, and incremental cost-effectiveness. Deterministic and probabilistic sensitivity analyses assessed uncertainty.
RESULTS: Rapid multiplex PCR testing was associated with lower total costs and shorter hospitalization compared with conventional microbiological culture. Total cost per patient was MKD 41,623.56 with rapid testing versus MKD 42,819.97 with conventional culture, generating savings of MKD 1,196.41 per patient. Mean hospital length of stay decreased from 13.00 to 9.51 days, corresponding to 3.49 hospital days avoided per patient. Overall, rapid multiplex PCR testing was dominant.
CONCLUSIONS: Rapid multiplex PCR testing was estimated to be a dominant diagnostic strategy for hospitalised pneumonia patients in North Macedonia. Earlier pathogen identification may support antimicrobial stewardship, reduce hospitalisation and improve resource use.
METHODS: A short-term cost-effectiveness model was developed to reflect an in-hospital episode of care in hospitalized patients with pneumonia. The analysis was conducted from a combined hospital and public payer perspective. Conventional microbiological culture was used as the standard-of-care comparator. The model captured the impact of earlier diagnostic results on treatment optimization, antimicrobial duration, hospital length of stay, and direct medical costs. Inputs were informed by published clinical evidence, local cost data, and real-world hospital information reflecting routine pneumonia management. Outcomes included total cost per patient, hospital days avoided, and incremental cost-effectiveness. Deterministic and probabilistic sensitivity analyses assessed uncertainty.
RESULTS: Rapid multiplex PCR testing was associated with lower total costs and shorter hospitalization compared with conventional microbiological culture. Total cost per patient was MKD 41,623.56 with rapid testing versus MKD 42,819.97 with conventional culture, generating savings of MKD 1,196.41 per patient. Mean hospital length of stay decreased from 13.00 to 9.51 days, corresponding to 3.49 hospital days avoided per patient. Overall, rapid multiplex PCR testing was dominant.
CONCLUSIONS: Rapid multiplex PCR testing was estimated to be a dominant diagnostic strategy for hospitalised pneumonia patients in North Macedonia. Earlier pathogen identification may support antimicrobial stewardship, reduce hospitalisation and improve resource use.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE38
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Medical Technologies
Disease
Infectious Disease (non-vaccine), No Additional Disease & Conditions/Specialized Treatment Areas, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)