Budget impact analysis of implementing point-of-care molecular testing for influenza A&B and RSV in Saudi older adult patients across hospital and home-care settings.

Introduction: The aim of our study is to compare the economic impact of adopting the molecular point-of-care test (mPOCT) for influenza A&B and RSV with current clinical judgment in Saudi Arabia, in both hospital-based and home care older adults.

Methodology: A static Budget Impact Analysis (BIA) was developed in Microsoft Excel to evaluate the clinical and economic consequences of adopting mPOCT for influenza A&B and RSV testing among prevalent older adult patients in Saudi Arabia. The model adopted the perspective of the Saudi healthcare system over a one-season horizon, comparing two diagnostic strategies: current practice based on clinical judgement and a future scenario using mPOCT in both older-adult-friendly hospitals and homecare settings. Parallel decision-tree structures were constructed for influenza and RSV, incorporating test accuracy, diagnostic outcomes, treatment pathways, hospitalization requirements, and mortality. Costs included diagnostics, staff time, outpatient visits, hospital stays, medications, and resources used for complications and inappropriate antibiotic prescribing. Epidemiologic, clinical, and cost inputs were derived from published evidence and supplemented with Saudi-specific data where available. A deterministic sensitivity analysis varied cost parameters ± 20% and clinical parameters across published confidence intervals.

Results: Adoption of the mPOCT was associated with substantial cost savings across all modeled (hospital and homecare settings) older adults. For Influenza A&B, total costs decreased from SAR 57,858,038 to SAR 26,933,837 in hospital settings and from SAR 13,254,535 to SAR 7,974,232 in homecare, yielding savings of SAR 30,924,201 and SAR 5,280,303, respectively. For RSV, hospital costs fell from SAR 40,640,192 to SAR 20,706,660, and homecare costs from SAR 9,157,462 to SAR 5,988,728, saving SAR 19,933,531 and SAR 3,168,733, respectively. Overall, mPOCT produced SAR 59,306,768 in combined savings, demonstrating strong economic value for respiratory infection management in Saudi Arabia.

Conclusion: This BIA demonstrates that implementing the mPOCT platform for influenza A&B and RSV in Saudi Arabia may provide substantial clinical and economic value, particularly for high-risk older adults. By enabling rapid and accurate diagnosis at both hospital and homecare entry points, mPOCT may significantly reduce false negatives, mitigates progression to severe lower respiratory tract infections, and decreases unnecessary antiviral and antibiotic use. These improvements could translate into major reductions in healthcare utilization, including ward and ICU admissions, and may generate considerable cost savings across a single respiratory season.