RESUMEN
PURPOSE: Next-generation sequencing (NGS) tools have clinical advantages over blood culture but are more expensive. This study assesses the budget impact and break-even point of NGS testing costs from a healthcare provider's perspective in Germany. METHODS: The budget impact was calculated based on aggregated data of German post-operative surgery cases. Simulated cost savings were calculated based on a simulated reduction in hospital length of stay (LOS) of four or eight days with a positivity rate of 71% and compared to the costs of one (scenario A) or two tests (scenario B) per case. Furthermore, the break-even point of the cost of two tests compared to saved costs through shortened LOS was conducted. RESULTS: For 9,450 cases, an average budget impact for scenario A and scenario B of 1,290.41 [95% CI 1,119.64 - 1,461.19] and - 208.59 [95% CI - 379.36 - - 37.81] was identified for gastrointestinal and kidney surgery cases, and 1,355.58 [95% CI 1,049.62 - 1,661.55] and 18.72 [95% CI - 324.69 - 287.24] for vascular artery surgery cases, respectively. The break-even analysis showed that using two tests per case could achieve a minimum positive contribution margin with an average of 1.9 tests per case across the study population. CONCLUSION: The results revealed a positive budget impact for one NGS test and a slightly negative budget impact for two NGS tests per case. Findings suggest that largest cost savings are generated for more severe cases and are highly dependent on the patient population.