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

Vinicius Queiroz Miranda Cedro; Stéfany de Lima Gomes; Ana Clara Correa Duarte Simões; Tatiana do Valle Lovato Sverzut; Keila Cristina Xavier Bertti; Marcelo Tadeu Tristão; Yuri Wanderley Cavalcanti; João Victor Frazão Câmara; Antonio Carlos Pereira

doi:10.1186/s12962-023-00469-1

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

Cost Eff Resour Alloc. 2023 Sep 13;21(1):64. doi: 10.1186/s12962-023-00469-1.

Authors

Vinicius Queiroz Miranda Cedro¹, Stéfany de Lima Gomes², Ana Clara Correa Duarte Simões², Tatiana do Valle Lovato Sverzut², Keila Cristina Xavier Bertti², Marcelo Tadeu Tristão², Yuri Wanderley Cavalcanti³, João Victor Frazão Câmara⁴, Antonio Carlos Pereira²

Affiliations

¹ Department of Community Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas - UNICAMP, Piracicaba, SP, Brazil. viniciusqcedro@gmail.com.
² Department of Community Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas - UNICAMP, Piracicaba, SP, Brazil.
³ Department of Clinical and Social Dentistry, Federal University of Paraíba, João Pessoa, Paraíba, Brazil.
⁴ Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University Hospital, Homburg/Saar, Germany.

Abstract

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: COVID-19; Cost-effectiveness evaluation; Unified Health System.