Does diagnostic testing always decrease antibiotics prescriptions?
Does diagnostic testing always decrease antibiotics prescriptions?
In August 2022, VALUE-Dx published a new article in the European Journal of Health Economics with the following title: ‘Does diagnostic testing always decrease antibiotics prescriptions?’. The conclusion of this scientific paper is that we should be very careful when we assert that point-of-care diagnostic testing (POCT) reduces antibiotics prescriptions as there are situations in which the opposite effect occurs.
Why POCT?
Empiric prescription as a treatment for infectious diseases in community care settings has caused antibiotics to be overprescribed, resulting in an increase of antimicrobial resistance (AMR). In order to reduce antibiotics prescription, point-of-care diagnostic testing (POCT) has been suggested.
In this new VALUE-Dx article, a stylised static theoretical economic model was used to analyse whether POCT always decreases antibiotics prescriptions. The interaction of a group of doctors who differ in their level of concern about AMR when prescribing with a firm selling a POCT was taken into consideration. The price set by the manufacturer and doctors’ decision to employ POCT was characterised.
Results of the study
It is widely accepted that the use of diagnostic testing to guide antibiotics prescription in community care settings reduces the number of antibiotics prescriptions. However, the model used in this article shows that we should be very careful with recommending the use of POCT to reduce antibiotics prescriptions as we may end up with the opposite result.
In fact, the number of antibiotics prescriptions is not always lower. It depends on the distribution of the doctors’ concern about AMR as there is a proportion of doctors who use POCT and then prescribe antibiotics, while other doctors change their prescribing behaviour after using POCT. They stop giving antibiotics to patients who do not benefit from them. When the proportion of patients who need antibiotic treatment is higher than the proportion of doctors who use POCT and stop prescribing unnecessary antibiotics, the number of antibiotics prescriptions is larger.
These analyses convey the message that we should be very careful when we assert that POCT reduces antibiotics prescriptions as there are situations in which the contrary effect is produced.
You can read the publication here.
