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Cost-effectiveness of a whole-area testing pilot of asymptomatic SARS-CoV-2 infections with lateral flow devices: a modelling and economic analysis study

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posted on 2022-10-12, 16:00 authored by Mark Drakesmith, Brendan Collins, Angela Jones, Kelechi Nnoaham, Daniel Rhys Thomas

 Background: Mass community testing for SARS-CoV-2 by lateral fow devices (LFDs) aims to reduce prevalence in the community. However its efectiveness as a public heath intervention is disputed. Method: Data from a mass testing pilot in the Borough of Merthyr Tydfl in late 2020 was used to model cases, hospitalisations, ICU admissions and deaths prevented. Further economic analysis with a healthcare perspective assessed cost-efectiveness in terms of healthcare costs avoided and QALYs gained. Results: An initial conservative estimate of 360 (95% CI: 311–418) cases were prevented by the mass testing, representing a would-be reduction of 11% of all cases diagnosed in Merthyr Tydfl residents during the same period. Modelling healthcare burden estimates that 24 (16—36) hospitalizations, 5 (3–6) ICU admissions and 15 (11–20) deaths were prevented, representing 6.37%, 11.1% and 8.2%, respectively of the actual counts during the same period. A less conservative, best-case scenario predicts 2333 (1764–3115) cases prevented, representing 80% reduction in wouldbe cases. Cost -efectiveness analysis indicates 108 (80–143) QALYs gained, an incremental cost-efectiveness ratio of £2,143 (£860-£4,175) per QALY gained and net monetary beneft of £6.2 m (£4.5 m-£8.4 m). In the best-case scenario, this increases to £15.9 m (£12.3 m-£20.5 m). Conclusions: A non-negligible number of cases, hospitalisations and deaths were prevented by the mass testing pilot. Considering QALYs gained and healthcare costs avoided, the pilot was cost-efective. These fndings suggest mass testing with LFDs in areas of high prevalence (>2%) is likely to provide signifcant public health beneft. It is not yet clear whether similar benefts will be obtained in low prevalence settings or with vaccination rollout 

History

Published in

BMC Health Services Research

Publisher

Springer

Version

  • VoR (Version of Record)

Citation

Drakesmith, M., Collins, B., Jones, A., Nnoaham, K. and Thomas, D.R. (2022) 'Cost-effectiveness of a whole-area testing pilot of asymptomatic SARS-CoV-2 infections with lateral flow devices: a modelling and economic analysis study',. BMC Health Services Research, 22(1), pp.1-12.

Electronic ISSN

1472-6963

Cardiff Met Affiliation

  • Cardiff School of Sport and Health Sciences

Cardiff Met Authors

Daniel Rhys Thomas

Cardiff Met Research Centre/Group

  • Microbiology & Infection

Copyright Holder

  • © The Authors

Language

  • en

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