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Table 6 Point of Care Testing Regime: Home HIVST Setting (Funded by Consumer)

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 HIVST+, EIA+, WB+ HIVST - HIVST +, EIA- HIVST+, EIA+, WB- HIVST+ EIA- HIVST -
Probability of result (PHIVSenHIVSTSenEIASenWB ) PHIV (1 − SenHIVST) (PHIVSenHIVST (1 − SenEIA)) ((1 − PHIV)  (1 − SpecHIVST)  (1 − SpecEIA) + SpecWB ) ((1 − PHIV)  (1 − SpecHIVST) SpecEIA ) (1 − PHIV) SpecHIVST
Inputs
Visit 1: Initial Screening
  Staffing Self Self Self Self Self Self
  OraQuick® In-Home HIV Test $54.75 $54.75 $54.75 $54.75 $54.75 $54.75
  Postage $7.50 $7.50 $7.50 $7.50 $7.50 $7.50
Confirmatory Testing conducted at Bulk Billing GP
Visit 1: Initial Screening
  Consult time 20 min   20 min 20 min 20 min  
  Medicare 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  
  Medicare Rebate $105.554   $71.701 $71.701 $71.701  
  Staffing GP   GP GP GP  
Total Cost of Each Outcome $284.15 $62.25 $221.30 $250.30 $221.30 $62.25
Total Cost of Each Outcome (excluding private costs) $221.90 $0 $159.05 $188.05 $159.05 $0
Average cost per person tested =(PHIVSenHIVSTSenEIASenWB) AC per True PositiveHIVST + , EIA + , WB+ + (PHIV (1 − SenHIVST)) AC per False NegativeHIVST + (PHIVSenHIVST (1 − SenEIA)) AC per False NegativeHIVST + , EIA + ((1 − PHIV) SpecHIVST) AC True NegativeHIVST + ((1 − PHIV)  (1 − SpecHIVST) SpecEIA) False PositiveHIVST + , EIA + ((1 − PHIV)  (1 − SpecHIVST)  (1 − SpecEIA) SpecWB) False PositiveHIVST + , EIA + , WB
Average number of tests for a positive diagnosis \( =\frac{1}{P_{HIV}\ast Se{n}_{HIV ST}\ast Se{n}_{EIA}\ast Se{n}_{WB}} \)
  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