| Title: |
The cost-effectiveness of procalcitonin for guiding antibiotic prescribing in individuals hospitalized with COVID-19: part of the PEACH study |
| Authors: |
Webb, E.J.D.; Howdon, D.; Bestwick, R.; King, N.; Sandoe, J.A.T.; Euden, J.; Grozeva, D.; West, R.; Howard, P.; Powell, N.; Albur, M.; Bond, S.; Brookes-Howell, L.; Dark, P.; Hellyer, T.; Llewelyn, M.; McCullagh, I.J.; Ogden, M.; Pallmann, P.; Parsons, H.; Partridge, D.; Shaw, D.; Szakmany, T.; Todd, S.; Thomas-Jones, E.; Carrol, E.D.; Shinkins, B.; Sandoe, J.; Carrol, E.; Henley, J.; Maboshe, W.; Bargiel, M.; Evans, J.; Webb, E.; Richman, C.; Gerver, S.; Hope, R.; Hopkins, S.; Heginbothom, M.; Berry, C.; Davis, G.; Wilkinson, V.; Taylor-Barr, E.; Brodsky, M.; Brown, J.; Burns, J.; Glynn, S.; Gureviciute, A.; Howard, M.; Kirkpatrick, J.; Murphy, H.; Richardson, E.; Scanlon, D.; Small, C.; Sweeney, G.; Williams, L.; Baker, E.; Cheema, Y.; Dunhill, J.; Killick, C.; King, C.; Kooner, S.; Lewis, S.; Nash, M.; Richardson, O.; Tuffney, J.; Westacott, C.; Williams, S.; Cawthron, K.; Tai, Y.K.; Newman, T.; Plowright, M.; Shulver, H.; Sivakova, A.; Ayliffe, F.; Darke, E.; Fletcher, E.; Hammonds, F.; Marquez, G.; Welch, L.; Lee-Milner, J.; Spencer, J.; Brandao, R.; Hrycaiczuk, J.; Stanley, J.; Cross, E.; Hansen, D.; Redmore, E.; Whyte, A.; McCullagh, I.; Brown, B.; Calabrese, M.; Cole, C.; DeSousa, J.; Dunn, L.; Grieveson, S.; Gulati, A.; Issac, E.; Mackay, R.; Simoes, F.; Apatri, E.; Charles, B.; Christensen, H.; Harvey, A.; Lomas, D.; Taylor, M.; Thomas, V.; Walker, D.; Howard, L.; Joseph, A.; Sultan, S.; Knox-Macaulay, C.; Prestwich, G.; Hamilton, R. |
| Publisher Information: |
Oxford University Press |
| Publication Year: |
2024 |
| Collection: |
White Rose Research Online (Universities of Leeds, Sheffield & York) |
| Description: |
Background Many hospitals introduced procalcitonin (PCT) testing to help diagnose bacterial coinfection in individuals with COVID-19, and guide antibiotic decision-making during the COVID-19 pandemic in the UK. Objectives Evaluating cost-effectiveness of using PCT to guide antibiotic decisions in individuals hospitalized with COVID-19, as part of a wider research programme. Methods Retrospective individual-level data on patients hospitalized with COVID-19 were collected from 11 NHS acute hospital Trusts and Health Boards from England and Wales, which varied in their use of baseline PCT testing during the first COVID-19 pandemic wave. A matched analysis (part of a wider analysis reported elsewhere) created groups of patients whose PCT was/was not tested at baseline. A model was created with combined decision tree/Markov phases, parameterized with quality-of-life/unit cost estimates from the literature, and used to estimate costs and quality-adjusted life years (QALYs). Cost-effectiveness was judged at a £20 000/QALY threshold. Uncertainty was characterized using bootstrapping. Results People who had baseline PCT testing had shorter general ward/ICU stays and spent less time on antibiotics, though with overlap between the groups’ 95% CIs. Those with baseline PCT testing accrued more QALYs (8.76 versus 8.62) and lower costs (£9830 versus £10 700). The point estimate was baseline PCT testing being dominant over no baseline testing, though with uncertainty: the probability of cost-effectiveness was 0.579 with a 1 year horizon and 0.872 with a lifetime horizon. Conclusions Using PCT to guide antibiotic therapy in individuals hospitalized with COVID-19 is more likely to be cost-effective than not, albeit with uncertainty. |
| Document Type: |
article in journal/newspaper |
| File Description: |
text |
| Language: |
English |
| ISSN: |
0305-7453 |
| Relation: |
https://eprints.whiterose.ac.uk/id/eprint/213848/11/dkae167.pdf; Webb, E.J.D. orcid.org/0000-0001-7918-839X , Howdon, D., Bestwick, R. et al. (132 more authors) (2024) The cost-effectiveness of procalcitonin for guiding antibiotic prescribing in individuals hospitalized with COVID-19: part of the PEACH study. Journal of Antimicrobial Chemotherapy, 79 (8). pp. 1831-1842. ISSN: 0305-7453 |
| Availability: |
https://eprints.whiterose.ac.uk/id/eprint/213848/; https://eprints.whiterose.ac.uk/id/eprint/213848/11/dkae167.pdf |
| Rights: |
cc_by_4 |
| Accession Number: |
edsbas.E9877A92 |
| Database: |
BASE |