Molecular diagnostic assays that test directly whole blood provide the ability to decrease inappropriate antimicrobial therapy and improve survival in patients with septic shock. We developed a decision analysis model to evaluate the cost-effectiveness of the addition of molecular assays to blood cultures in adults admitted to medical ICUs with septic shock. Under baseline assumptions, the use of molecular diagnostic methods was cost-saving in all cases that the length of hospital stay differed by 2 and 4 days between patients receiving appropriate and inappropriate antimicrobial therapy. In the case that the length of stay was the same, the use of molecular methods was cost-effective with an estimated incremental cost-effectiveness ratio (ICER) < $3000 per death averted. In the extreme that the length of stay between the 2 groups was the same, the highest cost reached was when the cost of the assay was $1000, with the estimated ICER being < $20,000 per death averted.
Keywords: Cost-effectiveness; ICU; Molecular assays; Rapid diagnostics; Septic shock.
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