Cost-consequence analysis of diagnostic strategies for suspected community-acquired pneumonia in France and Spain

AIMS: The study evaluated clinical and health economic consequences of two diagnostic strategies, standard of care (SOC) and SOC plus MeMed BV (MMBV; a host-response test designed to discriminate between bacterial and viral infections), for suspected community-acquired pneumonia (CAP) in adults from a French and Spanish healthcare perspective. METHODS: A cost-consequence analysis using a decision tree for adults presenting to the emergency department with suspected CAP. The time horizon was less than one year, modeling a hypothetical cohort of 1,000 patients with low-to-moderate disease severity. Clinical outputs were derived from published studies; unit costs were sourced from national or regional tariffs and cost studies. Deterministic one-way sensitivity analyses accounted for uncertainty in model parameters. RESULTS: In the base case analysis, SOC + MMBV was cost-saving versus SOC alone in both countries. The total cost per 1,000 patients decreased from €523,557 to €304,064 in France and from €467,356 to €267,786 in Spain, resulting in savings of approximately €220 and €200 per patient, respectively. The cost of MMBV was offset by reductions in other diagnostic tests and hospital admissions. Per 1,000 patients, SOC + MMBV correctly identified 181 more viral infections than SOC alone, resulting in 181 fewer unnecessary antibiotic prescriptions and almost 600 fewer additional diagnostic tests performed. LIMITATIONS: Key limitations include use of a simplified patient pathway, assuming correctly diagnosed patients are not admitted due to clinical deterioration, and a short-term time horizon focused on immediate clinical and economic outcomes. Conclusion Adding MMBV to SOC for adults with suspected CAP in EDs may be cost-saving for public payers in France and Spain. CONCLUSION: Adding MMBV to SOC for adults with suspected CAP in EDs can be cost-saving for public payers in France and Spain.