Let’s aim for an affordable and consistent corona test

India is one of the worst affected countries in the world in terms of outbreak of Kovid epidemic. As of 29 April 2021, the country has crossed 3 million active cases and recorded 200,000 deaths. With signs of vaccine shortage and a three-fold increase in the number of daily cases in the second wave, it is more important than ever to detect new infections and test for the spread of Kovid. In addition, full vaccination coverage at the current rate of 2 million per day will still take several months. Also, the efficacy of the vaccine against new mutations is unknown, or the duration of immunity provided by Jabs is unknown. Therefore, extensive, effective and equitable testing is a key element in our overall response to the epidemic.

The current test rate in India is lower than that. For better pandemic control, anyone who wants the test dynamics to be tested can get one. In low-middle-middle-income countries like India, being able to bear the test is a crucial decision maker. Therefore, test prices play an important role in determining the test rate. While the government’s policy of price caps makes a difference here, it is financially inefficient. Price reductions should flow from ironing out the inefficiencies in the value chain. Last year, the cost in India of the Reverse Transcription-Polymerase Chain Reaction (RT-PCR) test, which is considered the gold standard for Kovid confirmation, dropped even further. The outbreak was less than 3,000 in the early days 650 now. Much of this is driven by increasing competition in the manufacturing sector and retail markets and by reducing the cost of consumer goods by scaling economies. However, new ways must be explored to improve the test rate and further reduce the cost of the test.

Here, we list several ways to reduce the cost of RT-PCR testing. First, in the name of our analysis in an upcoming study Drivers improving the cost efficiency of the Kovid-19 test in India Procurement of test consumables through a unified and pooled procurement process in which a central agency negotiates with different vendors and delivers the product uniformly and at a very low cost to all buyers, thereby reducing the cost of testing in the public sector by over 40%. Second, according to our estimates, pool testing (combining several samples in one batch and then testing a lot) can reduce the cost of testing for public labs by over 50%. Third, combining a pooled test with a unified collection can reduce the unit cost of the test by an additional 15%. Therefore, by implementing these two strategies, the cost of RT-PCR testing can be reduced by over 60%. Fourth, optimizing processes, using the lab network for optimal load balancing, and effective sample collection and transport protocols can help achieve further cost reductions. Finally, our testing approach should be conducive to the active engagement of the private sector. Active participation in private labs reduces the burden on public infrastructure and promotes a competitive ecosystem, thus further reducing testing costs.

In addition to using the cost reduction levers mentioned above, it is important to create a consistent testing framework. Careful cost-benefit evaluation of health care innovations such as novel testing strategies, methods and techniques plays a key role. Proper use of different novel testing techniques such as Antigen + RT-PCR, where everyone is first tested by a rapid antigen test and given a diagnostic RT-PCR test only for the ratio of ‘positive’ individuals, can optimize the use of the RT-PCR kit supply. New investments from the government and the private sector in advanced artificial intelligence healthcare technologies, developed by Mumbai-based QureiI, could reduce the initial screening burden on RT-PCR infrastructure. Assessing the merits and incentive-compatibility of new technologies can meet specific testing needs such as FELODA, Abbott Antigen and Spectralite, rapid turnaround time and / or remote, which breaks trade-offs between accuracy, cost and accessibility. Test. In addition to health care innovations, reducing dependence on other countries by promoting domestic production also plays a good role in sustaining our testing efforts. Domestic production of test-kit components may not immediately provide the benefits of economies that some other countries enjoy, which may help in creating a stable, sustainable and resilient supply system that will help us prepare for similar situations in the future. .

The ongoing second wave has shown that our fight against Kovid is far from over. Establishing an affordable, equitable and sustainable system for testing is critical in solving the current epidemic. In addition, the improvements we are making now in India’s examination framework will keep us in good shape for a long time to come.

Note: Although the authors have come through careful calculations, there have been many predictions in the analysis that could lead to a departure from the actual numbers.

Ashish Sachdeva & Aman Kabra, Research Director and Analyst at the Indian School of Business, Max Institute of Healthcare Management.

Sarang Dio, Executive Director, Max Institute of Healthcare Management and Professor of Operations Management at the Indian School of Business, contributed to this column.

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