Cost-effectiveness analysis of COVID-19 tests in the unified health system

• Published in: Cost effectiveness and resource allocation Vol. 21; no. 1; pp. 1 - 64
• Main Authors: Cedro, Vinicius Queiroz Miranda, de Lima Gomes, Stéfany, Simões, Ana Clara Correa Duarte, Sverzut, Tatiana do Valle Lovato, Bertti, Keila Cristina Xavier, Tristão, Marcelo Tadeu, Cavalcanti, Yuri Wanderley, Câmara, João Victor Frazão, Pereira, Antonio Carlos
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 13-09-2023; BioMed Central; BMC
• Subjects: Accuracy; Antigens; Comparative analysis; Coronaviruses; Cost analysis; Cost benefit analysis; Cost-effectiveness evaluation; COVID-19; Diagnostic tests; Discount rates; Disease transmission; Economic analysis; Economic aspects; Health care industry; Human Development Index; Medical research; Pandemics; Severe acute respiratory syndrome coronavirus 2; Taxonomy; Unified Health System; Viruses; Wages & salaries; Brazil
• ISSN: 1478-7547; 1478-7547
• DOI: 10.1186/s12962-023-00469-1

Background To evaluate the cost-effectiveness ratio and economic impact of the Rapid Antigen Test (TR-Ag) to replace RT-PCR for the detection of the new Coronavirus in the Unified Health System (SUS). Methods This is a cost-effectiveness analysis. Clinical protocols were used for the diagnosis of COVID-19 at the São José Municipal Hospital, located in the city of Itaberá-SP. The Incremental Cost-Effectiveness Ratio (ICER) was divided into two scenarios. In the first, the accuracy reported by the test manufacturers was included, and in the second, the cost resulting from a systematic review. Both were compared with the performance of the RT-PCR test. The increase in diagnoses was chosen as a health outcome and absenteeism was used as a criterion for assessing the economic impact. Results The analysis resulted in incremental cost-effectiveness ratios of R$ 42,136.67 and R$ 68,329.73 for every thousand tests, according to the accuracy of the manufacturers' TR-Ag tests and what is reported in the literature in relation to RT-PCR, respectively. The average value found for the RT-PCR test (R$ 202.87) represents an increase of 165.32% in cost in relation to the value found for the TR-Ag. 4,305 tests were performed between April 2020 and December 2021 at the referral hospital. Also, maintaining the use of RT-PCR as the first choice for diagnosing COVID-19 and regulating absenteeism in the economically active population could have an impact of up to R$ 1,022,779.68 on municipal management. Conclusion It is concluded that the TR-Ag are configured as a cost-effective alternative for the SUS in the detection of the new Coronavirus. The strategy becomes economically favorable for the expansion of testing, combating the COVID-19 pandemic and reducing the impact on the local economy. However, studies are needed to validate the accuracy of the tests so that economic evaluations on the subject are more assertive. Keywords: Cost-effectiveness evaluation, COVID-19, Unified Health System