The value of fast diagnostics in time-critical infections

Advancing earlier intervention in time‑critical infections

Sepsis continues to impose a substantial global burden, with millions of cases and high mortality each year. Patients with bloodstream infections face a considerable risk of rapid deterioration, yet current diagnostic pathways return actionable information only after multiple days. These delays limit clinicians’ ability to deliver timely, targeted antimicrobial therapy, which increases mortality risk. Fast diagnostic technologies offer a way to close this gap, but their broader contributions remain undervalued and inconsistently recognised across health systems.

This report addresses this gap through a multi‑country economic evaluation examining how fast identification and antimicrobial susceptibility testing can improve outcomes and reduce health system costs for adults hospitalised with bloodstream infections at high risk of progressing to sepsis. The analysis covers seven major health systems (Canada, France, Germany, Italy, Japan, the United Kingdom, and the United States) and incorporates expert‑validated clinical inputs, country‑specific cost data, and conservative assumptions. The findings show meaningful health gains, substantial cost savings, and consistent economic dominance of fast diagnostics relative to current standard diagnostic pathways.

Why earlier diagnostic information matters

Conventional diagnostic methods rely on culture‑dependent workflows that require two to three days to return definitive results, prolonging time to appropriate therapy and increasing the likelihood of clinical deterioration. Evidence indicates that fast identification and susceptibility testing can significantly shorten this interval, reducing progression from bloodstream infection to sepsis and lowering mortality among patients who do develop sepsis or septic shock.

The clinical consequences of delayed targeted therapy extend into the long term. Survivors face high rates of post-sepsis complications such as cardiovascular, renal, cognitive, and psychological sequelae, each associated with additional care needs and reduced quality of life. 

What this study evaluates

This health economic analysis compares standard diagnostic pathways with fast identification and susceptibility testing across Canada, France, Germany, Italy, Japan, the United Kingdom, and the United States. A decision tree model captures the effects of faster actionable results on clinical progression, mortality, post-sepsis consequences, quality-adjusted life expectancy, and health system costs. The time horizon spans the index hospitalisation period, and a 12-month follow-up.

Country-specific evidence was drawn from published studies, administrative data, and clinical expert review. In cases where local evidence was unavailable, validated proxy data were used to maintain conservative assumptions. Sensitivity, probabilistic, and scenario analyses were performed to test robustness.

Key findings and their significance

Across all countries, fast diagnostics improve patient outcomes and reduce healthcare costs.

• Faster actionable results reduce sepsis cases, prevent avoidable deaths, and lower the incidence of post‑sepsis complications.
• Per patient savings range from several hundred to several thousand euros (or equivalent), reflecting avoided deterioration and reduced long-term care needs.
• At a population level, savings range from tens of millions to several billions annually depending on country size and disease burden.
• Most savings occur during the initial hospitalisation phase, where preventing progression to severe states such as septic shock avoids resource intensive care. 

Robustness testing confirms that fast diagnostics remain cost saving across a wide range of assumptions and scenarios, with a high probability of generating both improved health outcomes and cost reductions even under conservative scenarios.

Implications for policy and practice

National strategies addressing infectious diseases and antimicrobial resistance increasingly highlight the role of fast diagnostics. This analysis provides economic evidence to support that emphasis, showing that adopting fast diagnostics can enable earlier intervention, prevent avoidable clinical deterioration, and reduce long‑term health system costs. Realising this value will require coordinated action to:

• strengthen evidence on diagnostic impact.
• expand evaluation frameworks to capture full system‑wide benefits.
• overhaul current approaches to reimbursement for diagnostics.
• embed fast diagnostics into clinical pathways with clear operational protocols.
• support clinician adoption through education and implementation support.
• bring the patient experience into public and regulatory consciousness.

Conclusions

Fast identification and susceptibility testing offer a timely and effective response to a major gap in sepsis care. By shortening the interval to appropriate therapy, they improve the chance of survival, reduce long term health loss, and generate substantial cost savings. Scaling their use will require updated policy, evaluation approaches, and system level support. As health systems continue to confront the escalating burden of sepsis and antimicrobial resistance, expanding access to fast diagnostics represents a practical and impactful opportunity to improve care and strengthen health system resilience.