OBJECTIVES:

Rapid diagnosis of COVID-19 is important for clinical management and reducing disease transmission. The objective of this study was to quantify the economic value of a sequential rapid molecular point of care (mPOC) testing approach for COVID-19 and influenza compared to laboratory-based reverse transcription polymerase chain reaction (RT-PCR) testing (central lab) in the outpatient setting in the UK, Germany and France.

METHODS:

A decision tree-based modeling approach was used to compare economic costs of mPOC testing for COVID-19 and, if negative, testing for influenza to central lab testing. The model considers the time horizon from symptomatic patients presenting for testing until the end of treatment or quarantine/isolation and captures potential additional transmission due to delayed test results. Two scenarios were considered: 1) patients treated at home and 2) patients who were subsequently hospitalized. Key model inputs included time to test result, test accuracy, and COVID-19 and influenza community prevalence, infectious periods, and reproduction numbers. Net economic value was comprised of testing costs, treatment costs, productivity losses, cost of facility isolation, and medical costs to treat secondary transmissions. A societal perspective was used, and multiple sensitivity analyses were performed to gauge the robustness of results.

RESULTS:

Sequential testing with mPOC was cost saving compared to central lab in all 3 countries with the societal perspective (including productivity losses from quarantine/isolation). Estimated per-patient savings were €263 in Germany, £74 in the UK, and €65 in France in the home treatment scenario. Estimated savings were greater in the moderate (hospitalized) scenario due to facility isolation costs (Germany: €1,284 per patient, UK: £446 per patient, France: €164 per patient). Results were highly sensitive to time to receive central lab results.

CONCLUSION

This study demonstrates that testing symptomatic patients for COVID-19 and influenza with mPOC may be cost-saving compared to central lab PCR testing.