An Economic Evaluation of Government-Funded COVID-19 Testing in Australia

Abstract

Objective Easy and equitable access to testing has been a cornerstone of the public health response to COVID-19. Currently in Australia, testing using polymerase chain reaction (PCR) tests for COVID-19 is free to the user, but government funding for rapid antigen tests (RATs) is limited. We conduct an economic analysis of alternative government policies regarding the funding of COVID-19 testing in Australia. Methods A decision tree model was developed to describe COVID-19 testing pathways for the Australian population over a 1-week period. The model outputs were analysed to estimate R numbers associated with alternative funding policies, which were used to estimate COVID-19 cases over a 6-month time horizon. Healthcare costs and quality-adjusted life-year (QALY) effects were applied to new COVID-19 cases. The model was populated using responses to a de novo population survey and published data sources. Results Compared with no government-funded COVID-19 testing, government-funded testing is estimated to generate large incremental net monetary benefits (INMBs), up to A$15 billion in the base-case analyses. Government-funded PCR testing and RATs for all is predicted to maximise INMBs in most tested scenarios, though funding RATs for all and not PCR tests has similar INMBs in many scenarios and generates higher benefits to costs ratios. Conclusions Our interpretation of the modelled analysis is that at the time of writing (July 2022), with high vaccination uptake in Australia and few other public health measures in place, Australian governments should consider reducing funding of PCR testing, for example, limiting capacity to essential workers and individuals with known risk factors for serious symptoms, and fund RATs for all.