Cost effectiveness of a point-of-care test for adenoviral conjunctivitis.
BACKGROUND
Conjunctivitis is a relatively common condition of the eye that can be caused by a number of different pathogens including bacteria and viruses. Clinical differentiation between adenoviral and bacterial conjunctivitis is difficult, often resulting in misdiagnosis and the provision of inappropriate treatment.


METHODS
A cost-effectiveness analysis was performed from a societal perspective using primary, secondary, published literature, and expert opinion data sources. The incremental costs and effects (cases of unnecessary antibiotic treatment avoided) for a rapid point-of-care test for adenoviral conjunctivitis (RPS Adeno Detector) were modeled.


RESULTS
Using base case values, the incremental cost of using no point-of-care test compared with the point-of-care test is $71.30 with 0.1786 cases of unnecessary antibiotic treatment. Extrapolating these costs to the entire U.S. population per annum, society could potentially save nearly $430 million currently spent on unnecessary medical care and avoid over 1 million cases of unnecessary antibiotic treatment. The no-point-of-care test strategy is both more costly and less effective; indicating that the point-of-care test strategy is the most cost-effective option. The results were robust to variation in key model parameters.


CONCLUSIONS
Through the use of a rapid point-of-care test for adenovirus, much of the cost to society caused by acute conjunctivitis can be avoided through more timely and accurate diagnosis.
Udeh
Belinda L
BL
Health Economics Consulting Group, LLC, Morristown, New Jersey, USA.
Schneider
John E
JE
Ohsfeldt
Robert L
RL
D000258:Adenovirus Infections, Human / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology; D003198:Computer Simulation; D003236:Conjunctivitis, Viral / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology; D003362:Cost-Benefit Analysis; D003951:Diagnostic Errors / Q000191:economics; D003955:Diagnostic Tests, Routine / Q000191:economics*; D017048:Health Care Costs; D006801:Humans; D017059:Models, Econometric; D004364:Pharmaceutical Preparations / Q000191:economics; D019095:Point-of-Care Systems; D015995:Prevalence; D012680:Sensitivity and Specificity; D014481:United States / Q000453:epidemiology
D004364:Pharmaceutical Preparations