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Penicillin allergy testing results in delabeling most allergy claimants and may be cost-saving. This study aimed to project whether penicillin allergy testing in patients reporting a penicillin allergy is cost-saving.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this economic evaluation study, we built decision models to project the economic impact of 2 strategies for a patient with a penicillin allergy label: (1) perform diagnostic testing (drug challenges, with or without skin tests); and (2) do not perform diagnostic testing. The health service perspective was adopted, considering costs with penicillin allergy tests, and with hospital bed-days\/outpatient visits, antibiotic use, and diagnostic testing. Twenty-four base case decision models were built, accounting for differences in the diagnostic workup, setting (inpatient vs outpatient) and geographic region. Uncertainty was explored via probabilistic sensitivity analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Penicillin allergy testing was cost-saving in all decision models built. For models assessing the performance of both skin tests and drug challenges, allergy testing resulted in average savings (in United States [US] dollars) of $657 for inpatients (US: $1444; Europe: $489) and $2746 for outpatients (US: $256; Europe: $6045). 75% of simulations obtained through probabilistic sensitivity analysis identified testing as the less costly option.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Penicillin allergy testing was projected to be cost-saving across different scenarios. These results are devised to inform guidelines, supporting the adoption of policies promoting widespread testing of patients with a penicillin allergy label.<\/jats:p><\/jats:sec>","DOI":"10.1093\/cid\/ciaa194","type":"journal-article","created":{"date-parts":[[2020,2,25]],"date-time":"2020-02-25T20:15:36Z","timestamp":1582661736000},"page":"924-938","source":"Crossref","is-referenced-by-count":88,"title":["Penicillin Allergy Testing Is Cost-Saving: An Economic Evaluation Study"],"prefix":"10.1093","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1277-3401","authenticated-orcid":false,"given":"Bernardo","family":"Sousa-Pinto","sequence":"first","affiliation":[{"name":"Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal"},{"name":"Center for Health Technology and Services Research, Porto, Portugal"},{"name":"Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal"}]},{"given":"Kimberly G","family":"Blumenthal","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA"},{"name":"Harvard Medical School, Boston, Massachusetts, USA"}]},{"given":"Eric","family":"Macy","sequence":"additional","affiliation":[{"name":"Department of Allergy, Southern California Permanente Medical Group, San Diego Medical Center, San Diego, California, USA"}]},{"given":"Ana Margarida","family":"Pereira","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal"},{"name":"Center for Health Technology and Services Research, Porto, Portugal"}]},{"given":"Lu\u00eds Filipe","family":"Azevedo","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal"},{"name":"Center for Health Technology and Services Research, Porto, Portugal"}]},{"given":"Lu\u00eds","family":"Delgado","sequence":"additional","affiliation":[{"name":"Center for Health Technology and Services Research, Porto, Portugal"},{"name":"Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal"}]},{"given":"Jo\u00e3o Almeida","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal"},{"name":"Center for Health Technology and Services Research, Porto, Portugal"}]}],"member":"286","published-online":{"date-parts":[[2020,2,28]]},"reference":[{"key":"2021031513295308800_CIT0001","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1016\/j.anai.2017.07.009","article-title":"Frequency of 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