Cost-Effectiveness Analysis of Rapid Test Compared to Polymerase Chain Reaction (PCR) in Patients with Acute Respiratory Syndrome

Med J Islam Repub Iran. 2022 Apr 16:36:36. doi: 10.47176/mjiri.36.36. eCollection 2022.

Abstract

Background: It is important to have a rapid and cost-effective laboratory test for the early diagnosis of respiratory diseases.The aim of this study was to analyze the cost-effectiveness of rapid tests and PCR in patients with suspected influenza. Methods: This study was a cost-effectiveness analysis from a community perspective that in which patients who were referred to the emergency department of selected hospitals of IUMS university with suspected respiratory symptoms of influenza were studied by convenience sampling method. The intervention and comparator were rapid tests and PCR respectively. effectiveness indicators in this study include sensitivity, specificity, positive and negative predictive value of both tests, and it examines costs from a community perspective. After drawing the decision tree model in the TreeAge software, the incremental cost-effectiveness ratio was calculated and to evaluate the strength of the analysis results, one-way and two-way sensitivity analyses on all cost and effectiveness parameters were used. Results: According to the findings of this study, the effectiveness index in rapid test and PCR is equal to 0.90 and 0.91, respectively, and the average cost of the two tests is equal to 62.157 and 201.37$, respectively, the ICERwas 25450.27 and the cost-effectiveness threshold was estimated equal to 6000 according to the per capita GDP of the country. One-way and two-way sensitivity analysis showed that the result of cost-effectiveness analysis did not change, and the rapid test is cost-effective. Conclusion: Rapid test is less costly and effective than PCR, but the cost difference is greater than the difference in effectiveness and in terms of effectiveness indicators, both diagnostic tests are almost similar, and this cost difference has led to the choice of the rapid test as a cost-effective option. Therefore, it is recommended that physicians prioritize rapid tests in the diagnosis of respiratory diseases.

Keywords: Cost-Effectiveness; PCR; Rapid Test; Respiratory Infections.