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Table 5 Point of Care Testing Regime: Community Peer Testing Service Setting (Funded by 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- DHC+, EIA- DHC+, EIA+, WB- DHC+ EIA- DHC-
Probability of result (PHIVSenDHCSenEIASenWB ) (PHIV (1 − SenDHC)) (PHIVSenDHC (1 − SenEIA)) ((1 − PHIV)  (1 − SpecDHC)  (1 − SpecEIA) + SpecWB ) ((1 − PHIV)  (1 − SpecDHC) SpecEIA ) (1 − PHIV) SpecDHC
Inputs
Visit 1: Initial Screening - Community Peer Testing Service
  Consult time 60 Min 30 Min 60 Min 60 Min 60 Min 30 Min
  Staff Wage (Rate/Hour): $45 $45 $45 $45 $45 $45
  Staffing Peer Peer Peer Peer Peer Peer
Pathology costs
  Rapid Alere (DHC) Determine Test $11 $11 $11 $11 $11 $11
Referral to Bulk Billing GP for Confirmatory Testing
Visit 1: Initial Screening
  Consult time 20 min   20 min 20 min 20 min  
  Medicate Rebate $71.701   $71.701 $71.701 $71.701  
  Staffing GP   GP GP GP  
Pathology costs
  EIA test $15.652   $15.652 $15.652 $15.652  
  WB confirmatory $29.003    $29.003   
Visit 2: Test Results
  Consult time 40 min   20 min 20 min 20 min  
  Medicate Rebate $105.554   $71.701 $71.701 $71.701  
  Staffing GP   GP GP GP  
Total Cost of Each Outcome $277.90 $33.50 $215.05 $244.05 $215.05 $33.50
Average cost per person tested =(PHIVSenDHCSenEIASenWB) AC per True PositiveDHC + , EIA + , WB+ + (PHIV (1 − SenDHC)) AC per False NegativeDHC + (PHIVSenDHC (1 − SenEIA)) AC per False NegativeDHC + , EIA + ((1 − PHIV) SpecDHC) AC True NegativeDHC + ((1 − PHIV)  (1 − SpecDHC) SpecEIA) False PositiveDHC + , EIA + ((1 − PHIV)  (1 − SpecDHC)  (1 − SpecEIA) SpecWB) False PositiveDHC + , EIA + , WB
Average number of tests for a positive diagnosis \( =\frac{1}{P_{HIV}\ast Se{n}_{DHC}\ast Se{n}_{EIA}\ast Se{n}_{WB}} \)
  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 36; 2 = Medicare Rebate Item 69,384; 3 = Medicare Rebate Item 69,387; 4 = Medicare Rebate Item 44