OBJECTIVES: Community-Acquired pneumonia (CAP) is a major cause of mortality worldwide. Appropriate and early antimicrobial therapy is important in treating patients with CAP. In a world where antimicrobial resistance (AMR) poses a significant global threat, drug-resistant infections contribute to nearly 5 million deaths every year. CAP patients suffer from inappropriate antibiotics prescription, due to the complexity in differentiating bacterial and viral pathogens, and this contributes to the rise of AMR and health expenditure. To address this issue, a Host-Response Diagnostic Test (HRDT) was developed to reliably differentiate bacterial and viral infections.

METHODS: A Budget Impact model was developed to evaluate the 1-year budgetary impact of a 5% HRDT uptake in Italy, considering all costs associated with treatment guided by the Standard of Care (SOC) and treatment guided by SOC + HRDT together, for adult CAP patients presenting to Emergency Departments (ED). Outcomes of the target population were simulated according to Pneumonia Severity Index (PSI), and cost savings were considered from the third-party payer and hospital perspectives. Epidemiological data were elaborated from a real-life evidence database and costs were inferred applying current Italian national tariffs and literature estimations.

RESULTS: 7.185 patients were expected to be diagnosed in the ED with SOC + HRDT in one year. The adoption of HRDT (omitting its cost) would allow for savings in the range €411.458-€2.592.842 for hospitals and €105.033-€672.303 for payers, respectively, depending on scenarios. Savings were based on the following components in an Italian setting: antibiotic patients and days saved, reduced hospital admissions, and reduced hospital length of stay. Cost of hospital stay was the main driver.

CONCLUSIONS: Combining HRDT with current SOC diagnostic process is expected to provide savings to both payers and hospitals in all scenarios.