OBJECTIVES:  To investigate the budget impact that incorporating rapid point-of-care (POC) diagnostic tests for Ebola virus (EBOV) diagnosis in addition to conventional testing would have had during the recent West African epidemic, from the perspective of Sierra Leone. METHODS:  A pragmatic literature review identified test-specific inputs including sensitivity, specificity and cost to test one patient. Hospital costs including cost per hospital-bed-day and treatment costs per case were identified. Costs were combined to estimate the total cost of testing and the total cost of the epidemic between June 2014–May 2015 and were inflated to 2014/2015 USD. Characteristics of the epidemic including the number of people seeking treatment daily, EBOV prevalence and total number of cases were derived from Nouvellet et al. 2015. A model was generated to compare the costs of three diagnosis strategies: reverse-transcription polymerase-chain-reaction (RT-PCR) alone, which is the gold-standard for EBOV diagnosis, POC-testing alone and dual-testing (POC tests used to sort patients with high-risk from those with low-risk of infection followed by RT-PCR for confirmation). RESULTS:  When costs of testing alone were analysed, RT-PCR was highest, with the dual strategy 1.4 times lower and POC-testing 12 times lower than RT-PCR. This was true for both literature-reported and assumed real-world sensitivities/specificities. Despite the high testing costs, when treatment-related costs were also considered, the dual strategy was associated with the lowest total epidemic costs, whilst epidemic costs were still highest with the conventional RT-PCR approach CONCLUSIONS:  A combined POC-testing and RT-PCR strategy would have resulted in lower testing and overall care costs during the EBOV epidemic in Sierra Leone in comparison to the approach of RT-PCR alone that was taken. This could be due to reduced nosocomial infection rates due to separation of high and low risk patients with the dual strategy. Nouvellet et al. 2015. Nature 528, S109-S116.