Skip to main content

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