Study: Annual costs for diagnostic tests up to $25B, antibody tests up to $19B

The estimated annual cost for diagnostic testing of COVID-19 will range from $6 billion to $25.1 billion, and the cost for antibody testing could vary from $5.2 billion to $19.1 billion, a new study found.

The study, sponsored by insurance lobbying group America’s Health Insurance Plans (AHIP), paints a picture of the costing for testing that will be pivotal for states reopening after months of lockdown due to the pandemic. Major insurers have agreed to cover the cost of testing for beneficiaries, but the extent of that testing remains up in the air.

“One of the key sources of uncertainty in annual costs in 2020 and 2021 is the utilization of diagnostic (i.e., molecular or antigen) and antibody testing,” the study conducted by consulting firm Wakely found. “The science behind testing is evolving quickly as research studies begin to show results and new types of tests are being offered.”

The estimates include both the costs for providing the test itself and any other affiliated healthcare costs like a trip to urgent care.

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The study looked at three purposes on how diagnostic or antibody COVID-19 testing could occur: medically necessary where a patient has symptoms, population health tests that analyze the prevalence of COVID-19 in a population and employee screening of asymptomatic individuals at work sites.

Wakely estimated that under current testing levels, the annual cost of COVID-19 diagnostic tests was $6 billion to $25.1 billion. Under a mass testing scenario, the cost jumps to between $13 billion and $25 billion.

The study predicts the mass testing scenario will occur when testing is broad such as for returning to work or school.

Antibody testing under current levels ranges from $5.2 billion to $16.4 billion and could rise to $12.2 billion to $19.1 billion under a mass testing scenario.

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“The science behind testing is evolving quickly as research studies begin to show results and new types of tests are being offered,” the study said. “While testing has expanded there is still much that the medical and public health communities are learning.”

Wakely developed the estimate based on the average costs for testing based on National Health Expenditure data.

A test’s estimated cost could vary between $50 to $100 for a diagnostic test reimbursed by Medicare and Medicaid and $40 to $60 for an antibody test.

The firm also looked at enrollment figures for Medicare Advantage and Medicaid from the Centers for Medicare & Medicaid Services and enrollment data published by the Kaiser Family Foundation.

AHIP said in a blog post that the study underscores the need for federal guidance to consider funding for testing.

The government also needs to “clearly articulate the roles of insurance providers, employers and public health officials,” AHIP added.