Modelling of hypothetical SARS-CoV-2 point of care tests for routine testing in residential care homes: rapid cost-effectiveness analysis

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus that causes disease 2019 (COVID-19), which at time of writing (January 2021) was responsible for more than 2.25 million deaths worldwide and over 100,000 in UK. SARS-CoV-2 appears to be highly transmissible could rapidly spread residential care homes. Objective The work undertaken aimed estimate clinical effectiveness cost-effectiveness viral detection point-of-care tests detecting compared with laboratory-based setting a hypothetical home facility elderly residents. Perspective/setting perspective NHS 2020. Care homes en suite rooms shared facilities were modelled separately. Methods A discrete event simulation model constructed individual residents simulate once it had entered facility. numbers COVID-19-related critical cases recorded addition number days spent isolation. Thirteen strategies involving different modelled. Recently published desirable acceptable target product profiles hospital-based Scenario analyses early release from isolation based on receipt negative test result impact vaccination. Incremental using both incremental ratios net monetary benefits. Results Cost-effectiveness results depended proportion penetrated by SARS-CoV-2. appear have high benefit values. In contrast, low values because unnecessary isolations. allowing whether or not rooms. greater assumed efficacy vaccination, lower associated tests, when assuming vaccine lowers risk contracting Limitations There considerable uncertainty key parameters within model, although calibration an attempt mitigate this. Some degree Monte Carlo sampling error persists timelines project. example simulated will also match those decision-makers deciding introducing tests. Given these limitations, should taken as indicative rather definitive, particularly relative cost per uncertain. Conclusions potential use facilities, but this materialises depends diagnostic accuracy costs forthcoming Future More accurate would obtained there certainty reduction used context levels immunity vaccination administered. These are currently Funding This report commissioned National Institute Health Research (NIHR) Evidence Synthesis programme project 132154. funded NIHR Technology Assessment full ; Vol. 25, No. 39. See Journals Library website further information.