Drivers of improving cost-efficiency of COVID-19 testing in India
Drivers of improving cost-efficiency of COVID-19 testing in India
Year: November 2020
Collaborator: Chase India and Rockefeller Foundation
Team: Hemanshu Das, Sarang Deo, Ayush Gupta, Aman Kabra, Ashish Sachdeva
Background
COVID-19 pandemic affected millions across the globe. India’s first reaction to the pandemic was decisive and swift – a complete lockdown. Additionally, masks were mandated, health facilities upgraded, private sector services onboarded and dedicated COVID care centres established. Despite these measures, India was one of the worst hit countries. The heterogeneous nature of the spread, as revealed by the seroprevalence studies, emphasizes the need for intensive testing. Widespread testing is essential to contain the spread of the virus.
About the Study
The study aimed to assess the cost-effectiveness of various COVID-19 tests such as Real-Time Polymerase Chain Reaction (RT-PCR), CBNAAT / TrueNat, Rapid Antigen, and pooled testing so as to provide recommendations to reduce per unit cost of tests for both urban and rural settings.
Methodology
In the study, we
(a) conducted a cost analysis of the RT-PCR test: calculated its per unit cost
(b) compare the cost of RT-PCR test with other tests
(c) make recommendations to reduce the cost of RT-PCR (or alternatives with lower costs and similar test sensitivity).
Firstly, we computed the unit cost of conducting RT-PCR and then compared it with the cost of conducting RAT, CBNAAT, TrueNAT, CRISPR + PCR tests and novel testing strategies. Based on this analysis we then provide specific recommendations to reduce the cost of RT-PCR testing.
Outcome
The largest cost drivers are collection and testing consumables (88%). The overall cost reduction can therefore be achieved through reduction in cost or usage of these components. Some of the strategies that can help in cost reduction are:
- Increased and Stable Supply (economies of scale)
- Consolidated and pooled procurement mechanisms (like IPAQT for TB testing reduced prices considerably)
- Pooled testing (pooling the samples and testing the pool. If the pool tests positive, testing all samples individually, otherwise not)