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Health Economic Evidence of Point-of-Care Testing: A Systematic Review

Author

Listed:
  • Deon Lingervelder

    (University of Twente)

  • Hendrik Koffijberg

    (University of Twente)

  • Ron Kusters

    (University of Twente
    Jeroen Bosch Hospital)

  • Maarten J. IJzerman

    (University of Twente
    University of Melbourne
    Victorian Comprehensive Cancer Centre)

Abstract

Objective Point-of-care testing (POCT) has become an essential diagnostic technology for optimal patient care. Its implementation, however, still falls behind. This paper reviews the available evidence on the health economic impact of introducing POCT to assess if poor POCT uptake may be related to lacking evidence. Study Design The Scopus and PubMed databases were searched to identify publications describing a health economic evaluation of a point-of-care (POC) test. Data were extracted from the included publications, including general and methodological characteristics as well as the study results summarized in either cost, effects or an incremental cost-effectiveness ratio. Results were sorted into six groups according to the POC test’s purpose (diagnosis, screening or monitoring) and care setting (primary care or secondary care). The reporting quality of the publications was determined using the CHEERS checklist. Results The initial search resulted in 396 publications, of which 44 met the inclusion criteria. Most of the evaluations were performed in a primary care setting (n = 31; 70.5%) compared with a secondary care setting (n = 13; 29.5%). About two thirds of the evaluations were on POC tests implemented with a diagnostic purpose (n = 28; 63.6%). More than 75% of evaluations concluded that POCT is recommended for implementation, although in some cases only under specific circumstances and conditions. Compliance with the CHEERS checklist items ranged from 20.8% to 100%, with an average reporting quality of 72.0%. Conclusion There were very few evaluations in this review that advised against the implementation of POCT. However, the uptake of POCT in many countries remains low. Even though the evaluations included in this review did not always include the full long-term benefits of POCT, it is clear that health economic evidence across a few dimensions of value already indicate the benefits of POCT. This suggests that the lack of evidence on POCT is not the primary barrier to its implementation and that the low uptake of these tests in clinical practice is due to (a combination of) other barriers. In this context, aspects around organization of care, support of clinicians and quality management may be crucial in the widespread implementation of POCT.

Suggested Citation

  • Deon Lingervelder & Hendrik Koffijberg & Ron Kusters & Maarten J. IJzerman, 2021. "Health Economic Evidence of Point-of-Care Testing: A Systematic Review," PharmacoEconomics - Open, Springer, vol. 5(2), pages 157-173, June.
    • Handle: RePEc:spr:pharmo:v:5:y:2021:i:2:d:10.1007_s41669-020-00248-1
    DOI: 10.1007/s41669-020-00248-1
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    References listed on IDEAS

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    1. Michelle M.A. Kip & Maarten J. IJzerman & Martin Henriksson & Tracy Merlin & Milton C. Weinstein & Charles E. Phelps & Ron Kusters & Hendrik Koffijberg, 2018. "Toward Alignment in the Reporting of Economic Evaluations of Diagnostic Tests and Biomarkers: The AGREEDT Checklist," Medical Decision Making, , vol. 38(7), pages 778-788, October.
    2. Douglas Coyle & Martin J. Buxton & Bernie J. O'Brien, 2003. "Stratified cost‐effectiveness analysis: a framework for establishing efficient limited use criteria," Health Economics, John Wiley & Sons, Ltd., vol. 12(5), pages 421-427, May.
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    1. Journal round-up: PharmacoEconomics – Open 5(2)
      by Rita Faria in The Academic Health Economists' Blog on 2021-07-26 06:00:01

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