Economic evaluation of laboratory diagnostic test types in Covid-19 epidemic: A systematic review. (September 2022) - Dolatshahi, Zeinab
Abstract: Background: Corona 2 virus (SARS-CoV-2) is known as the causative agent of COVID-19 disease; the World Health Organization (WHO) declared it an epidemic on March 11, 2020. The Joint Guidelines of the Centers for Disease Control and Prevention (CDC) and the WHO including social distancing, the use of face masks, emphasis on hand washing, quarantine, and using diagnosis tests have been used widely, but the value of diagnostic interventions to prevent the transmission of SARS-CoV-2 is unclear. We compared the economic evaluation of different laboratory diagnostic interventions with each other and also with implementing the conservative CDC & WHO guidelines. Material and methods: Electronic searches were conducted on PubMed, Embase, Science Direct, Scopus, Cochrane Library, Web of Knowledge, NHSEED, NHS Health Technology assessment (CRD), and Cost-Effectiveness Analysis Registry databases. Related articles were reviewed from January 2020 to the end of November 2021. Results: Out of 1791 initial studies, 13 articles had the inclusion criteria. According to the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist, ten studies were of excellent quality, and the remaining two studies were of very good quality. Most studies were cost-effectiveness analysis studies. The entered studies had different time horizons. Diagnostic tests reviewed in the studies included real-time polymerase chain reaction (RT-PCR) test, immunoglobulin G (IgG) & Antigen, point of care tests. Although polymerase chain reaction (PCR) testing improves the quality of life and survival for patients with infected Covid-19 based on its greater effectiveness compared to standard protection protocols, due to the high cost of this intervention, it has been considered a cost-effective method in some countries. Conclusion: Since most studies have been conducted in developed countries, it unquestionably does not make sense to extend these results to low-income and developing countries. Therefore further studies are required in low-income and developing countries to evaluate the cost-effectiveness of laboratory-based diagnostic methods (RT-PCR) of covid-19 in variable prevalence of infectious cases. Highlights: The Covid-19 pandemic has left an increased rate of mortality and generated unknown morbidities, as well imposed as huge economic costs on the entire world, estimated to exceed $ 21 trillion by 2020. The policymakers, in middle-low-income countries, may be misled due to the high cost of PCR testing, although, the results show that in the high prevalence of Covid-19, these testing methods, PCR, rapid POCT, and serological, convert into a dominant and cost-effective intervention in detecting infected people and naturally reducing hospitalization or isolation. Further studies in low-income and developing countries are needed to evaluate the cost-effectiveness of laboratory-based diagnostic methods (RT-PCR) in the variable prevalence of infections for successful exposure to emerging viral diseases.