Discrete choice experiment to determine what levels of reimbursement and financial incentive lead to the greatest uptake amongst UK GPs of a diagnostic test to inform antibiotic prescribing

Antibiotic resistance is largely driven by the unnecessary use of antibiotics and occurs when antibiotics are no longer effective at treating bacterial infections. It presents a serious public health challenge with both economic and population health costs. Diagnostic tests exist that can help clinicians differentiate between viral and bacterial case presentation, which may reduce unnecessary antibiotic use. However, these tests are not always used, and countries with higher test‑usage rates are often those that provide some reimbursement or additional financial incentive for their use. In the UK, there is no reimbursement or financial incentive offered for these tests. The aim of this project was to assess the incentive‑response of UK GPs if such an incentive were offered.

This study used a discrete choice experiment (DCE) to evaluate the predicted behavioural response of UK GPs if reimbursement and a financial incentive were to be offered for C‑reactive protein (CRP) tests when consulting for a patient presenting with symptoms indicative of respiratory infection.

This study was designed in collaboration with clinicians, aiming to present scenarios that may occur in general practice. Results from this study indicate that if reimbursement or a financial incentive were offered, UK GPs would be likely to increase their use of CRP tests for patients presenting with symptoms indicative of a respiratory infection. This suggests that if such an intervention were introduced, it may be able to improve the use of these existing diagnostic tests, with potential implications for mitigating antimicrobial resistance.