Drakesmith, Mark, Collins, Brendan 
ORCID: 0000-0002-3023-8189, Jones, Angela, Nnoaham, Kelechi and Thomas, Daniel Rhys
(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).
1190-.
Abstract
<h4>Background</h4>Mass community testing for SARS-CoV-2 by lateral flow devices (LFDs) aims to reduce prevalence in the community. However its effectiveness as a public heath intervention is disputed.<h4>Method</h4>Data from a mass testing pilot in the Borough of Merthyr Tydfil in late 2020 was used to model cases, hospitalisations, ICU admissions and deaths prevented. Further economic analysis with a healthcare perspective assessed cost-effectiveness in terms of healthcare costs avoided and QALYs gained.<h4>Results</h4>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 Tydfil 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 would-be cases. Cost -effectiveness analysis indicates 108 (80-143) QALYs gained, an incremental cost-effectiveness ratio of £2,143 (£860-£4,175) per QALY gained and net monetary benefit 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).<h4>Conclusions</h4>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-effective. These findings suggest mass testing with LFDs in areas of high prevalence (> 2%) is likely to provide significant public health benefit. It is not yet clear whether similar benefits will be obtained in low prevalence settings or with vaccination rollout.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Covid-19, SARS-CoV-2, Lateral flow test, Mass testing, Community testing, Cost-effectiveness, Economic analysis, Epidemiological modelling, QALYs |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Population Health |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 27 Sep 2022 10:19 |
| Last Modified: | 18 Jan 2023 20:41 |
| DOI: | 10.1186/s12913-022-08511-3 |
| Open Access URL: | https://bmchealthservres.biomedcentral.com/article... |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3164979 |
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