Skip to main content

Table 4 Parallel Testing Regime: Community Peer Testing Service using Volunteer Peer Nurse Setting (Funded by Federal Government - Medicare and State Government)

From: Economic evaluation of alternative testing regimes and settings to detect undiagnosed HIV in Australia

 

True HIV Positive (PHIV)

True HIV Negative (1 − PHIV)

Outcomes

DHC+, EIA+, WB+

DHC-, EIA+, WB+

DHC+, EIA-

DHC-, EIA-

DHC+, EIA-

DHC+, EIA+, WB-

DHC-, EIA+,

WB-

DHC-, EIA-

Probability of result

(PHIVSenDHCSenEIASenWB )

(PHIV (1 − SenDHC) SenEIASenWB )

(PHIVSenDHC (1 − SenEIA))

(PHIV

(1 − SenDHC)  (1 − SenEIA))

((1 − PHIV)  (1 − SpecDHC) SpecEIA )

((1 − PHIV)  (1 − SpecDHC)  (1 − SpecEIA) SpecWB )

((1 − PHIV) SpecDHC (1 − SpecEIA) SpecWB )

((1 − PHIV) SpecDHCSpecEIA )

Inputs

Visit 1: Initial Screening – Volunteer Peer Testing Facilitators

  Consult time

20 min

20 min

20 min

20 min

20 min

20 min

20 min

20 min

  Staff Wage (Rate/Hour):

$0

$0

$0

$0

$0

$0

$0

$0

  Staffing

Volunteer Nurse

Volunteer Nurse

Volunteer Nurse

Volunteer Nurse

Volunteer Nurse

Volunteer Nurse

Volunteer Nurse

Volunteer Nurse

Pathology costs

  Rapid Alere Determine Test

$11

$11

$11

$11

$11

$11

$11

$11

  EIA test

$15.651

$15.651

$15.651

$15.651

$15.651

$15.651

$15.651

$15.651

  WB confirmatory

$29.002

$29.002

   

$29.002

$29.002

 

Visit 2: Test Results – Community Peer Organisation Bulk Billing GP Clinic

  Consult time

40 min

40 min

20 min

 

20 min

20 min

20 min

 

  Medicate Rebate

$105.553

$105.553

$71.704

 

$71.704

$71.704

$71.704

 

  Staffing

GP

GP

GP

 

GP

GP

GP

 

Total Cost of Each Outcome

$161.20

$161.20

$98.35

$26.65

$98.35

$127.35

$127.35

$26.65

Average cost per person tested

=(PHIVSenDHCSenEIASenWB) AC per True HIV PositiveDHC + , EIA + , WB+ + (PHIV (1 − SenDHC) SenEIASenWB) AC per True HIV PositiveDHC − , EIA + , WB+ + (PHIVSenDHC (1 − SenEIA)) AC per False NegativeDHC + , EIA + (PHIV (1 − SenDHC)  (1 − SenEIA)) AC per False NegativeDHC − , EIA + ((1 − PHIV)  (1 − SpecDHC) SpecEIA) AC per False HIV PositiveDHC + , EIA + ((1 − PHIV)  (1 − SpecDHC)  (1 − SpecEIA) SpecWB) AC per False HIV PositiveDHC + , EIA + , WB + ((1 − PHIV) SpecDHC (1 − SpecEIA) SpecWB) AC per False HIV PositiveDHC − , EIA + , WB + ((1 − PHIV) SpecDHCSpecEIA) AC per True NegativeDHC − , EIA

Average number of tests for a positive diagnosis

\( =\frac{1}{\left({P}_{HIV}\ast Se{n}_{DHC}\ast Se{n}_{EIA}\ast Se{n}_{WB}\right)+\left({P}_{HIV}\ast \left(1- Se{n}_{DHC}\right)\ast Se{n}_{EIA}\ast Se{n}_{WB}\right)} \)

  1. Note: AC Average Cost, DHC Alere Determine™ HIV-1/2 Ag/Ab Combo Test, EIA fourth generation enzyme immunoassay test, GP General Practitioner, P Probability, Sen Sensitivity, Spec Specificity, WB Western Blot Test, + reactive test result, − nonreactive test result. 1 = Medicare Rebate Item 69,384; 2 = Medicare Rebate Item 69,387; 3 = Medicare Rebate Item 44; 4 = Medicare Rebate Item 36