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      EPH120 Comparing the Effectiveness and Cost-Effectiveness of SARS-COV-2 Screening Strategies Using Rapid Antigen Tests in a Residential College Campus

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      1 , 1 , 1 , 2
      Value in Health
      Published by Elsevier Inc.

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          Abstract

          Objective To compare the effectiveness and cost-effectiveness of SARS-CoV-2 screening strategies using rapid antigen tests in a residential college campus. Methods A compartmental epidemic model was developed from published sources, primarily from Paltiel et al. JAMA Network Open 2020. In model development we identified several needed corrections to the published model which were confirmed with the lead published author. Our model was verified against all published numeric outcomes of Paltiel (2020). Our modeling study included a hypothetical cohort of 5000 students – 4990 students without SARS-CoV-2 infection and ten with undetected, asymptomatic SARS-CoV-2 infection. The screening strategies that we evaluated were symptom-based screening and tests of varying frequency (i.e., every 1, 2, 3, and 7 days) and sensitivity (i.e., 40, 50, and 60%). These three levels of sensitivity were based on published values for rapid antigen tests, e.g., 35.8% for asymptomatic persons and 64.2% for symptomatic persons (Prince-Guerra et al. MMWR Morb Mortal Wkly Rep. 2021). Specificity was set to 98%, the test cost to $10, and reproductive number (Rt) to 2.5. Model projections were for an 80-day, abbreviated semester. Results Within each sensitivity level (i.e., 40, 50, and 60%), screening frequency order of every 7, 3, 2, and 1 days was associated with increasing costs (range $682,000-$4,639,200) and increasing infections averted (range 1202-4797). In terms of cost-effectiveness, for sensitivity levels 40 and 50%, the 7-day screening intervals were dominated. For each sensitivity level, the incremental cost-effectiveness ratio (ICER, $ per infection averted) increased with increased testing frequency. In general, as the test sensitivity increased, ICERs increased, i.e., at higher sensitivities the cost to avert an infection increases as the test frequency increases. Conclusion From an effectiveness standpoint, more frequent testing is preferable. From a cost-effectiveness standpoint, even for poorly sensitive tests, screening every three days is an attractive option.

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          Author and article information

          Journal
          Value Health
          Value Health
          Value in Health
          Published by Elsevier Inc.
          1098-3015
          1524-4733
          25 June 2022
          July 2022
          25 June 2022
          : 25
          : 7
          : S456-S457
          Affiliations
          [1 ]Medical Decision Modeling Inc., Indianapolis, IN, USA
          [2 ]Purdue University, West Lafayette, IN, USA
          Article
          S1098-3015(22)01072-5
          10.1016/j.jval.2022.04.871
          9232802
          48e7d838-da95-4538-95f4-30e605dfda1c
          Copyright © 2022 Published by Elsevier Inc.

          Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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          Economics of health & social care
          Economics of health & social care

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