Cost implications of introducing the BIOFIRE FILMARRAY meningitis/encephalitis panel vs. real-time PCR in adult and pediatric populations in the UK

Meningitis is a life-threatening infection of the protective membranes surrounding the brain and spinal cord, requiring early and accurate diagnosis to inform clinical management. Standard diagnostic methods, a mix of cerebrospinal fluid (CSF) culture and polymerase chain reaction (PCR) testing, can be constrained by delayed processing or reduced sensitivity following antibiotic administration. The BIOFIRE FILMARRAY Meningitis/Encephalitis (ME) Panel is a rapid multiplex PCR test that detects 14 specific pathogens from a CSF sample in approximately 1 h, thereby avoiding multiple targeted assays, accelerating diagnostic turnaround, and reducing the cumulative diagnostic burden. A cost-consequence model was developed from the United Kingdom (UK) National Health Service (NHS) perspective for adults and children with suspected or confirmed meningitis. The model includes costs (diagnostic, treatment, hospital stay) and consequences (time to targeted treatment, antimicrobial use, length of stay) over a per-episode time horizon, from initial presentation through inpatient discharge. Results indicate that the panel reduced total costs compared to real-time PCR by 8.4% in adults and 15.7% in children with suspected meningitis, and by 7.8% and 14.0% in confirmed cases, respectively. The results indicate that the BIOFIRE ME panel may improve clinical outcomes while reducing NHS resource use, aligning with national goals to optimize antimicrobial stewardship and hospital efficiency.