Flu testing is usually not cost-effective

Studies suggest physician judgment may be a sounder means of diagnosing and treating influenza.

By Victoria Stagg Elliott, amednews staff. March 1, 2004.

When Michael Bornstein, MD, a pediatrician in Sugar Land, Texas, has a child in his office whom he suspects might have influenza, he performs a rapid test for presence of the virus. In about 10 minutes, the test gives him guidance on whether to prescribe antivirals, antibiotics or neither. The information also gives parents a clearer picture of why their child is sick and convinces them to be more vigilant in complying with the treatment.

"It is impossible to give children these medications," said Dr. Bornstein. Many are more likely to spit a medicine out than swallow it. "If I run the test and it turns out positive, parents will get that medicine in one way or another."

Dr. Bornstein is part of a growing cadre of physicians who have incorporated rapid flu testing into their practices. The cost of this trend, however, is coming under scrutiny with a growing number of researchers asking if the test -- with its price tag of approximately $20-- is worth the money.

Most recently, a study in the January/February Annals of Family Medicine suggested that, in most instances, a physician's clinical judgment combined with antiviral treatment is the most cost-effective strategy.

Researchers at the Medical University of South Carolina analyzed the costs of no treatment, testing and treatment, and empirical treatment for a hypothetical group of adults at high risk for influenza complications. Testing was only beneficial when flu prevalence was between 30% and 40% and the most expensive antivirals were being prescribed. The authors suggest that testing may be useful for public health surveillance but not necessarily the best option for the average primary care medical practice.

[...]

Full text of American Medical News content is available to AMA members and paid subscribers.

Access details

Join the AMA