The value of diagnostics to combat antimicrobial resistance by optimising antibiotic use


If we want to tackle anti-microbial resistance (AMR), we need to ensure that antibiotics are only used when absolutely necessary. However, data shows that in Europe, 30-50% of antibiotics are prescribed unnecessarily. Greater use of diagnostic tests could help to bring this figure down by ensuring that doctors only prescribe antibiotics when absolutely necessary. However, the wider use of diagnostic tests in healthcare is hampered by a lack of insight into their medical, technological and health economical value. In addition, our knowledge about the barriers to their use remains limited. The goal of VALUE-Dx is to generate evidence on the medical, economic, and public health value of diagnostics in treating AMR. The team, which includes six diagnostic companies, will also develop user requirement specifications of tests. The project will focus on respiratory tract infections in community care settings, as these are a common cause of inappropriate antibiotic use. However, the project’s findings are also likely to be relevant for other common infections, including urinary tract infections, blood stream infections, and respiratory tract infections acquired in hospitals. Ultimately, VALUE-Dx should help to transform medical practice by making it easier for doctors to deliver personalised, evidence-based antibiotic prescriptions thanks to the use of innovative diagnostic strategies.

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Antibiotics economics: rapid tests are worth it when confidence is low

Fighting drug-resistant bacteria requires prescribing fewer antibiotics. VALUE-Dx lay out the economic calculations behind decisions to use point-of-care tests.###

Every doctor differs in their level of uncertainty about whether or not to prescribe an antibiotic. When they feel very certain that a patient’s symptoms are caused by a bacterial infection, an antibiotics prescription is often made promptly and confidently. The problem arises when the level of certainty dips below a certain threshold. In these cases, point-of-care tests are a worthy investment for doctors and wider society: beyond avoiding unnecessary prescriptions, they increase doctors’ confidence in their diagnosis, while also sensitising them to the risks of getting it wrong.

Those are the conclusions of a study carried out by the IMI project VALUE-Dx, as laid out in a paper in Health Economics Review. The authors’ cost-benefit calculations describe the level of uncertainty that would drive a hypothetical subset of physicians to use a point-of-care test, as well as the considerations of a hypothetical manufacturer trying to figure out how much doctors might be willing to pay for the equipment. They created an economic model that frames the dilemma in purely monetary terms, in the hope that they can once and for all demonstrate the real-world value of rapid diagnosis in primary care.

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EFPIA companies
  • Abbott Rapid Dx International Limited, galway, Ireland
  • Bio-Rad, Marnes-La-Coquette, France
  • Biomerieux SA, Marcy L'Etoile, France
  • Janssen Pharmaceutica Nv, Beerse, Belgium
Universities, research organisations, public bodies, non-profit groups
  • Academisch Ziekenhuis Groningen, Groningen, Netherlands
  • Bioaster Fondation De Cooperation Scientifique, Lyon, France
  • European Respiratory Society, Lausanne, Switzerland
  • European Society Clinical Microbiology Infectious Diseases (Europaische Gesellschaft Fur Klinische Mikrobiologie Infektionskrankheiten), Basel, Switzerland
  • Fondazione PENTA - for the treatment and care of children with HIV-ONLUS, Padova, Italy
  • Foundation For Innovative New Diagnostics, Geneva, Switzerland
  • Gesundheit Osterreich GMBH, Wien, Austria
  • National Institute For Health And Care Excellence, Manchester, United Kingdom
  • The Health Corporation - Rambam, Haifa, Israel
  • The Trustees Of Boston University, Boston Ma, United States
  • The University Of Edinburgh, Edinburgh, United Kingdom
  • Universidad De La Rioja, Logrono, Spain
  • Universita Degli Studi Di Verona, Verona, Italy
  • Universitair Medisch Centrum Utrecht, Utrecht, Netherlands
  • Universiteit Antwerpen, Antwerp, Belgium
  • University of Oxford, Oxford, United Kingdom
  • Zorgonderzoek Nederland Zon, Den Haag, Netherlands
Small and medium-sized enterprises (SMEs) and mid-sized companies (<€500 m turnover)
  • Berry Consultants Llp, London, United Kingdom
Associated partners
  • Bd Switzerland SARL, Eysins, Switzerland
  • The Wellcome Trust Limited, London, United Kingdom
Third parties
  • Universitair Ziekenhuis Antwerpen, Edegem, Belgium

NameEU funding in €
Academisch Ziekenhuis Groningen353 972
Berry Consultants Llp69 688
Bioaster Fondation De Cooperation Scientifique63 842
European Respiratory Society127 226
European Society Clinical Microbiology Infectious Diseases (Europaische Gesellschaft Fur Klinische Mikrobiologie Infektionskrankheiten)126 508
Fondazione PENTA - for the treatment and care of children with HIV-ONLUS665 349
Foundation For Innovative New Diagnostics74 930
Gesundheit Osterreich GMBH85 190
Luxembourg Institute Of Health (left the project)2 587
National Institute For Health And Care Excellence181 631
The Health Corporation - Rambam88 409
The Trustees Of Boston University15 053
The University Of Edinburgh72 916
Universidad De La Rioja154 475
Universita Degli Studi Di Verona488 786
Universitair Medisch Centrum Utrecht1 152 248
Universiteit Antwerpen1 454 223
University of Oxford1 584 809
Zorgonderzoek Nederland Zon33 392
Third parties
NameFunding in €
Universitair Ziekenhuis Antwerpen3 866
Total Cost6 799 100