Cost-effectiveness of anti-SARS-CoV-2 antibody diagnostic tests in Brazil

• Autor(a) principal: Tália Santana Machado de Assis
• Data de Publicação: 2022
• Outros Autores: Mariana Lourenço Freire, Janaína de Pina Carvalho, Ana Rabello, Glaucia Fernandes Cota
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UFMG
• Texto Completo: https://doi.org/10.1371/journal.pone.0264159; http://hdl.handle.net/1843/61860; https://orcid.org/0000-0003-0538-7403
• topic: Anti-SARS-CoV-2; Diagnostic tests; Cost-effectiveness; Brazil; Teste para COVID-19; Avaliação de Custo-Efetividade; Brasil

Background Although serologic tests for COVID-19 diagnosis are rarely indicated nowadays, they remain commercially available and widely used in Brazil. The objective of this study was to evaluate the cost-effectiveness of anti-SARS-CoV-2antibody diagnostic tests for COVID-19 in Brazil. Methods Eleven commercially available diagnostic tests, comprising five lateral-flow immunochromatographic assays (LFAs) and six immunoenzymatic assays (ELISA) were analyzed from the perspective of the Brazilian Unified Health System. Results The direct costs of LFAs ranged from US$ 11.42 to US$ 17.41and of ELISAs, from US$ 6.59 to US$ 10.31. Considering an estimated disease prevalence between 5% and 10%, the anti-SARS-CoV-2 ELISA (IgG) was the most cost-effective test, followed by the rapid One Step COVID-19 Test, at an incremental cost-effectiveness ratio of US$ 2.52 and US$ 1.26 per properly diagnosed case, respectively. Considering only the LFAs, at the same prevalence estimates, two tests, the COVID-19 IgG/IgM and the One Step COVID-19 Test, showed high effectiveness at similar costs. For situations where the estimated probability of disease is 50%, the LFAs are more costly and less effective alternatives. Conclusions Nowadays there are few indications for the use of serologic tests in the diagnosis of COVID-19 and numerous commercially available tests, with marked differences are observed among them. In general, LFA tests are more cost-effective for estimated low-COVID-19- prevalences, while ELISAs are more cost-effective for high-pretest-probability scenarios.