Economic evaluation of vancomycin-resistant enterococci (VRE) control practices: a systematic review

Area of Science:

• Healthcare Economics
• Infectious Disease Control
• Public Health Policy

Background:

• Preventing vancomycin-resistant enterococci (VRE) infections is crucial in healthcare settings.
• The economic impact and cost-effectiveness of VRE control measures remain uncertain.
• Evidence synthesis is needed to guide resource allocation for VRE prevention.

Purpose of the Study:

• To systematically review and synthesize economic evaluations of VRE control practices.
• To assess the cost-effectiveness and cost-saving potential of interventions like screening and contact precautions.
• To identify gaps in the evidence regarding the economic value of VRE control.

Main Methods:

• Literature search of economic evaluations of VRE control practices from January 1985 to June 2018.
• Inclusion of studies from hospital settings published in English.
• Screening of 4711 articles, with nine primary studies meeting the inclusion criteria.
• Analysis of cost-effectiveness and cost-consequence studies from a hospital perspective.

Main Results:

• Most studies (N=7) utilized cost-effectiveness analysis; two used cost-consequence analysis.
• Four studies indicated enhanced VRE control practices were cost-effective or cost-saving.
• Three studies suggested decreasing VRE control practices was cost-effective or cost-saving.
• Three studies found discontinuing VRE-specific control practices was not cost-effective.

Conclusions:

• Current evidence suggests VRE screening and contact precautions are often cost-effective.
• Significant heterogeneity in interventions and low study quality limit definitive conclusions.
• High-quality economic evaluations are necessary to establish the cost-effectiveness of specific VRE control strategies.