Presentation (CTI)

OBJECTIVES: During the COVID-19 pandemic, development of respiratory tests expanded beyond individual tests for COVID-19 to small and large panel multi-pathogen tests. While larger panels may simplify diagnosis, testing for more than the most common circulating pathogens may be unnecessary for otherwise healthy individuals. This study reviewed trends in respiratory PCR testing in the year before and after the end of the PHE on 05/11/2023.
METHODS: Using de-identified claims data from the Optum Labs Data Warehouse, commercial and Medicare Advantage (MA) enrollees ≥18y with a claim for a respiratory PCR test were identified in each monthly period in the year before (05/12/2022 to 05/11/2023) and the year after (05/12/2023 to 05/11/2024) the PHE end date. In each monthly period, the percentage of enrollees with ≥1 respiratory PCR test was reported; tests on the patient’s first test date were categorized as individual pathogen, small panel (2-5 pathogens), large panel (≥6 pathogens), or multiple types.
RESULTS: Overall, 5,947,807 observations (56% commercial, 44% MA) of respiratory testing were identified, 72% before and 28% after the PHE end date. Monthly rates of respiratory testing among enrollees ranged between 0.8% and 3.1% in the year before and 0.4% and 1.3% in the year after the PHE end date. Test type distribution was 72% individual pathogen, 20% small panel, 2% large panel, and 6% multiple before the PHE end date and 36% individual pathogen, 45% small panel, 5% large panel, and 14% multiple after the PHE end date.
CONCLUSIONS: Rates of PCR respiratory testing declined after the COVID-19 PHE end date. Test type shifted from primarily individual pathogen tests during the PHE to small panel or multiple test types after the PHE end date. While use of large panels doubled among patients with testing, overall rates of large panel testing remained low across the population.