SMARTPHONE-ENHANCED RAPID INFLUENZA TESTS: A COST-EFFECTIVENESS ANALYSIS

Research show rapid influenza diagnostics have sensitivity ranging 50-70% and specificity ranging 90-95%. In response, researchers at the University of Washington are developing a novel smartphone-enhanced rapid flu test. The user-friendly diagnostic could be offered at more points of outpatient care. Our objective was to evaluate the potential cost-effectiveness in various settings—compared to the standard test in a clinic. We created a decision tree to model the lifetime costs and health outcomes of non-hospitalized US adults (18-64 and ≥65) within 48 hours of developing a temperature >100 degrees and a cough or sore throat (i.e., influenza-like illness (ILI)). The reference group was patients at an outpatient primary care clinic visit for ILI receiving a standard rapid test flu followed by prescription of a neuraminidase inhibitor based on test results and clinical judgment. Comparison groups received the smartphone test through a physician, nurse, pharmacist, or self-administration. CDC influenza surveillance data were incorporated to predict cost-effectiveness for each week of the year to reflect the seasonality of flu. At an additional price of $1 per test, all smartphone diagnostic scenarios resulted in more QALYs and fewer total costs compared to a standard test (dominant ICERs). The greatest benefit was among adults 18-64 using the smartphone-enhanced test at a pharmacy during the off-season for flu (INMB = $124 per person). Most QALY gains were by avoiding treatment side effects in people with non-flu illnesses. Patients benefitted by avoiding productivity loss and payers were predicted to avoid costs of unnecessary drugs and side effects. This economic decision model of a smartphone-enhanced influenza diagnostic projects that the new product could in result cost savings, health gains, and greatest value for patients aged 18-64 when administered in a pharmacy or at home during the off-season for flu.