Frankfurt School of Finance & Management, Adickesallee 32-34, 60322, Frankfurt am Main, Germany.
BMC Health Serv Res. 2022 Jan 10;22(1):47. doi: 10.1186/s12913-021-07277-4.
The aim of this study is to quantify the health benefits, risks, and cost-effectiveness of COVID-19 self-tests from a consumer's perspective in Germany.
The analysis is based on a modelling approach using secondary data. The clinical endpoints considered in this analysis are avoided SARS-CoV-2 infections and secondary severe clinical events (death, intensive care unit (ICU) admission, and long COVID syndrome). The study determines the number of self-tests that need to be conducted under a 7-day incidence of 75 per 100,000 population to prevent one infection or severe clinical event. Furthermore, the study calculates the cost of testing per avoided clinical event and quality-adjusted life year (QALY) gained from a consumer perspective.
Disregarding the rate of unreported COVID-19 cases, 4556 self-tests need to be conducted (over 12 years) in order to avoid one undesirable event (death, intensive care unit stay, or long COVID syndrome). Ninety percent of infections are not avoided among direct contacts but along the chain of infection. The costs per quality-adjusted life year gained from a consumer's perspective are €5870. This ratio is particularly sensitive to the 7-day incidence, effective reproduction number, and the age of contacts.
The benefits of self-testing in the general population at a 7-day incidence rate of 75 per 100,000 appear to be minor. Nevertheless, cost-effectiveness may still be acceptable in the presence of higher-risk contacts given the low costs of self-test kits in Germany.
本研究旨在从消费者的角度量化德国 COVID-19 自测试的健康效益、风险和成本效益。
该分析基于使用二级数据的建模方法。本分析中考虑的临床终点是避免 SARS-CoV-2 感染和二次严重临床事件（死亡、重症监护病房（ICU）入院和长新冠综合征）。该研究确定了在 75 例/10 万人口的 7 天发病率下需要进行多少次自我检测，以预防一次感染或严重临床事件。此外，该研究还从消费者的角度计算了每避免一次临床事件和每获得一个质量调整生命年（QALY）的检测成本。
不考虑未报告的 COVID-19 病例的比率，需要进行 4556 次自我检测（超过 12 年），以避免一次不良事件（死亡、入住重症监护病房或长新冠综合征）。90%的感染不会在直接接触者中避免，但会在感染链中避免。从消费者的角度来看，每获得一个质量调整生命年的成本为 5870 欧元。这个比率对 7 天发病率、有效繁殖数和接触者的年龄特别敏感。
在 75 例/10 万人口的 7 天发病率下，普通人群进行自我检测的收益似乎很小。然而，鉴于德国自我检测试剂盒的成本较低，在存在高风险接触者的情况下，其成本效益仍可能是可以接受的。
