A few days ago we reported that the NFZ had reduced the valuation of coronavirus tests. As it turns out, the valuation proposed by the NFZ results from the analysis of the Agency for Health Technology Assessment and Evaluation (AOTMiT).
AOTMiT has collected data from dozens of laboratories
According to the new NFZ valuation, the Fund currently pays PLN 280 for a molecular test for coronavirus (without test costs, it is PLN 140). This amount for the test was also proposed by AOTMiT. The Agency’s valuation was based on data collected from the NIZP National Institute of Hygiene, 11 Provincial Sanitary and Epidemiological Stations, three Regional Blood Donation and Blood Management Centres and 17 other laboratories. Additionally, AOTMiT established cooperation with an expert working as an analyst in one of the laboratories performing such tests. He described each stage of the process of performing the SARS-CoV-2 test for SARS-CoV-2 using the PCR method with particular emphasis on cost data and the amount of equipment and materials needed.
According to the data provided by the laboratories, the average cost of performing a coronavirus test is PLN 194 (cost range from PLN 40 to PLN 402). As far as the cost of the test is concerned, the average cost is PLN 135 (cost range from PLN 72 to PLN 205). However, it should be borne in mind that these are raw data provided by the laboratories, which may be subject to an error, e.g. incorrect conversion of costs into one sample.
Material and personal protective equipment costs
In order to assess the performance of the coronavirus test, AOTMiT divided it into three components, each of which was estimated separately. The first of these was material costs. These are the costs of laboratory materials i.e. pipette tips, tubes, plates, disinfectants. These costs also include the cost of equipment for taking test material (so-called swabs), as most laboratories provide them on their own. However, the cost of taking the material from the patient was not included, as it is included in the cost of other services financed by the National Health Fund.
AOTMiT estimated separately the cost of personal protective equipment for employees. The suits, nitrile gloves, rubber gloves, protective (surgical) masks, protective (filter) masks, glasses/goggles, visors, apron, cap, protectors were included. For each category the average price from the prices given by the laboratories and the average consumption per test performed were calculated.
The second component is personnel costs. They have been estimated on the basis of the salary data provided by the units for laboratory diagnosticians and lab technicians, technicians and assistants. These costs do not take into account the mode of operation of the laboratories. The third component is infrastructure costs.
AOTMiT: It is difficult to price a test with the cost of the test
Average material, personnel and infrastructure costs per test were estimated by AOTMiT at PLN 140. These calculations were made on the basis of daily numbers of tests performed declared by the entities that provided the data. These numbers ranged from 28 to 276, 140 on average, with nearly half of the laboratories below 100.
At the same time, AOTMiT stresses that the costs of the tests for coronavirus themselves are widely priced and that there are different practices for buying them. They are purchased from own resources, obtained from the Ministry of Health and used only in part (e.g. only for RT-PCR testing, as the laboratory has a part for isolation of the material in its own resources). Some laboratories also receive samples that have already undergone an RNA isolation process. It is therefore difficult to clearly assess the benefit of the test together with the cost of the test. However, assuming the average price of the test, calculated on the basis of data provided by the laboratories, AOTMiT proposes to set the valuation of this benefit at PLN 280.32.
At the same time, the Agency stipulates that if tests with a significantly lower price appear on the market and they can be widely used, this valuation should be reviewed.