Procalcitonin (PCT) testing has shown clinical utility for indicating antibiotic use in patients suspected of sepsis or other serious bacterial infections, but hospitals have balked at implementing it routinely due to its cost. An AACC webinar on May 31 will explore the economic value of PCT-guided therapy that labs and pharmacies should consider.
Biomarkers that assist clinicians and pharmacists in more effective use of antibiotics are critical in hospitals today, Lotte Steuten, PhD, told CLN Stat. Steuten, an associate faculty member/professor with the University of Washington’s Fred Hutchinson Cancer Research Center in Seattle, will join Mike Broyles, PharmD, director of pharmacy and laboratory services at Five Rivers Medical Center in Pocahontas, Arkansas, to co-present the webinar.
One-third of all prescribed antibiotics aren’t necessary. For this reason, “PCT can play a critical role in helping to reduce the increasing antibiotic resistance, decreasing adverse effects from antimicrobials such as C. difficile, and helping to reduce overall healthcare costs by helping healthcare providers determine when to start and stop antibiotics in certain conditions,” Steuten said. Since the U.S. Food and Drug Administration’s clearance of sensitive PCT methods for use in antibiotic stewardship, many U.S. diagnostic companies are now offering these tests to use in antibiotic stewardship efforts, she added.
PCT testing may initially cost labs more in disposable costs, but over time actually saves hospitals expenses involving drug costs, 30-day readmissions, mortality, C. difficile infections, adverse drug events, overall inpatient lab and radiology procedures, and longer lengths of stay, Broyles told CLN Stat. According to Steuten, the total cost savings of PCT-guided antibiotic use versus standard of care ranges from 20%-30%. “Expected reductions in antibiotic resistance range from 5%-23%, and reductions in C. difficile infections range from 55%-63% in populations of patients hospitalized with suspected sepsis or lower respiratory tract infection,” she said.
It is important to place cost and value contributions of PCT in the proper perspective, Broyles advised. Most departments within a hospital operate with a “silo” mentality and feel pressure to meet operating budgets. “The budgetary process is commonly a painful annual process with the C-suite to determine costs of services, salaries, and capital expenditures,” Broyles observed. “Labs may be concerned with new instrumentation, wages, and expendable testing costs. Pharmacy is often concerned with rising drug expenditures and wages.” Hospitals need to consider several factors in evaluating PCT testing to guide antibiotic therapy, he said.
Labs may see the addition of PCT as an additional expense that could hurt their budgets. “Conversely, they may appreciate the need for better stewardship and the value PCT brings to reducing antibiotic use and reducing numerous other patient and health economic outcomes,” Broyles said. In contrast, pharmacy departments may view PCT as another project requiring time and attention in an already overworked environment. However, they may also see the potential value it brings to the arena of antibiotic stewardship. The benefits for patients and hospitals may override the educational learning curve for proper PCT use. “Where these two groups fall depends on pressures relating to budget, wages, perception of the need for stewardship, appreciation of the new Centers for Medicare and Medicaid Services and The Joint Commission regulations, and a myriad of other factors,” Broyles said.
Webinar participants will learn about:
- The cost and effectiveness of a PCT algorithm guide to antibiotic use compared to standard of care using published U.S. studies;
- Real-world examples of PCT-aided antibiotic therapy decisions from a pharmacy and laboratory perspective; and
- How to interpret the potential application of health economic analysis results to their own institutions.
Departments need to work together as a team, with the understanding that patient and health economic outcomes far overshadow the cost of PCT testing, Broyles noted.
Register now for Health Economic Value of PCT Testing in the U.S. on May 31. You’ll earn 1 ACCENT credit and gain a wealth of new information about PCT testing.