Molecular Testing for Respiratory Tract Infections May Have Favorable Impact on Real-world Healthcare Costs

Molecular testing by Polymerase Chain Reaction (PCR) has improved diagnostic performance to inform appropriate treatment. However, its impact on healthcare utilization and costs related to respiratory tract infections are yet to be studied in detail. The aim of this study is to evaluate the costs of healthcare utilization following traditional culture and molecular PCR diagnostic testing for respiratory tract infections. Real-world healthcare costs were evaluated over 4-weeks in patients (n = 1,362,226) with an upper respiratory tract infection who received a PCR test, compared to patients who received no test or who received a culture test in the Marketscan® Commercial Database by Merative™. Compared to culture ($586.32+$600.04 PMPM), the PCR test ($353.42+$291.95 PMPM) and no test cohorts ($377.19+$279.35 PMPM) were associated with lower total costs over a 4-week period. A significant component of this was attributed to lower pharmacy costs in the PCR cohort ($35.90+5.87) compared to the culture cohort ($61.10+9.11 PMPM) (p = 0.005). Given the dual global threats of respiratory infections and antibiotic resistance, this real-world observational analysis shows the potential for molecular testing to favorably impact subsequent healthcare utilization and costs.