Penicillin Allergy Delabeling Program: an exploratory economic evaluation in the Australian context

Area of Science:

• Health Economics
• Pharmacovigilance
• Clinical Allergy Management

Background:

• International studies highlight clinical and economic benefits of penicillin delabelling.
• Integrating penicillin delabelling into routine inpatient care is supported by healthcare delivery system changes.

Purpose of the Study:

• To evaluate the economic advantages of low-risk inpatient penicillin delabelling in Australia.
• To compare the cost-effectiveness of inpatient versus outpatient penicillin allergy testing.

Main Methods:

• An explorative economic evaluation using prospective patient data from two Australian health services (Jan-Aug 2019).
• Part 1 compared cost per effectively delabelled patient between the Penicillin Allergy Delabeling Program (PADP) inpatient cohort and Outpatient Antibiotic Allergy Testing Service (OAATS) outpatient cohort.
• Part 2 compared hospital costs for inpatients with low-risk penicillin allergy who did (PADP) or did not (usual care) undergo delabelling.

Main Results:

• The PADP cohort incurred lower costs ($20.51 per effectively delabelled patient) compared to OAATS ($362 per effectively delabelled patient), indicating significant savings.
• Inpatient delabelling via PADP resulted in an average reduction of 4.41 days in hospital stay and savings of $9467.72 per patient compared to usual care.
• Outpatient allergy testing (OAATS) was found to be a dominated strategy, being more costly and less effective than inpatient delabelling.

Conclusions:

• Penicillin allergy delabelling in the inpatient setting demonstrates economic advantages within the Australian healthcare context.
• Findings align with international literature supporting the cost-effectiveness of penicillin delabelling.
• Further fully powered economic evaluations are recommended to solidify these findings.