Table 1 Summary of existing cost-analyses for penicillin allergy evaluation based on intervention type and principal provider
Study | Country | Study Design | Population | Intervention Type | Principal Provider | Cost Parameters | Findings | Inflation Adjusted Findings** |
|---|---|---|---|---|---|---|---|---|
Dodek (1999) | Canada | A decision analysis | Inpatient adult | PST + OC | Allergist | Supplies and allergy consultation | PST + DC= $123.15CAD/patient | PST + DC= $186.00 |
Macy (2014) | USA | Retrospective, matched cohort study | Inpatient adult | PST + OC | Registered Nurse | Supplies and nursing time | PST + DC= $131.37USD/patient | PST + DC= $184.35 |
Ferre-Ybarz (2015) | Spain | Retrospective descriptive analysis | Outpatient n = 100 Pedatric and adult | DC vs. complete evaluation | Allergist | Allergist visit + PST + Labs + multi-dose challenge | DC= €97.19/patient PST + DC= €149.30 /patient | DC=$162.09 PST + DC= $249.00 |
King (2016) | USA | Retrospective analysis | Inpatient n = 50 Age ≥ 18 years | PST + OC | Allergist | PST materials | Materials alone= $96.80USD/patient | Material= $131.88 |
Chen. (2018) | USA | Single-center, quasi-experimentall study | Inpatient n = 58 Age ≥ 18 years | PST + OC | Allergy-trained pharmacist | Supplies and pharmacist time | PST + DC= $220USD/patient | PST + DC= $288.58 |
Blumenthal (2018) | USA | Time-driven activity based cost analysis | Outpatient n = 30 | PST + OC | Allergist vs. nurse practitioner | Summative cost of personnel, consumables and space | PST + DC=$220 USD/patient if (allergist) PST + DC=$170 USD/patient (nurse practitioner) | PST + DC= $288.58 (allergist) PST + DC= $222.99 (NP led |
Sobrino-Garcia (2019) | Spain | Single-center, prospective observational study | Outpatient n = 296 Age: ≥14 | PST + OC | Allergist | Healthcare (service, materials) and non-healthcare (commute to clinic visits) direct costs, and | PST + DC=€95.2 Total costs including indirect costs estimated at €187.49 | PST + DC= $147.72 |
Mustafa (2019) | USA | Randomized control trial | Outpatient n = 159 Age: ≥ 5 years | DC vs. PST + OC | Allergist | Allergy/immunology billing for PST, DC | DC=$107.32USD/patient PST + DC=$447.32USD/patient | DC=$138.78 PST + DC= $578.40 |
Ramsey (2020) | USA | Single-center, prospective, nonrandomized | Inpatient n = 100 Age: ≥ 18 years | DC vs. PST + OC | Infectious disease pharmacist | Supplies and pharmacist time | DC=$206.18USD/patient PST + DC=$419.63USD/patient | DC=$260.36 PST + DC= $529.90 |
Chua (2021) | Australia | Single-center, prospective, nonrandomized (assigned based on oral penicillin challenge guideline) | Inpatient n = 355 Age: ≥ 18 years | DC | Infectious disease physicians | Cost-analysis assuming ward staff can complete de-labeling tests within usual duties | DC=$35.18AUD/patient AUD=$15.52 if staff consent patient | DC=$32.36 ($14.27 if nusing consents patients) |