Tests For COVID-19 Are Expensive, But They Don’t Have To Be

(Posted on Wednesday, April 8, 2020)

There is a huge demand around the world to understand Covid-19. Those experiencing symptoms need to know if they’re infected, while those recovered need to know if they’re able to return to work.

The problem of developing technology that can address the crisis has already been solved. Genome amplification tests are available that measure the presence of the Covid-19 virus, SARS-CoV-2, over the course of the disease.

Antibody tests, also known as serology tests, reveal whether you’ve been infected, the stage of infection, whether you’ve recovered, and whether you’re likely immune to further infection.

What continues to be a problem is the availability of tests, on the one hand—and on the other hand, their cost.

How much should COVID-19 tests cost? Fortunately, we have a measure from a universal screening program recently completed in Egypt that can give us a reasonable estimate. Through the 100 Million Healthy Lives program, from October 2018 onward, either genome or serology tests were performed on the majority of Egyptians 12 and over: a total of 65 million people.

Although the main goal was to reduce rates of hepatitis C infection—Egypt had the highest in the world at the time—testing was also conducted for diseases like diabetes, hypertension, and obesity. Results were logged using handheld tablets that also recorded age, sex, and geographical data. In no small part due to this program, Egypt may become the first country to eliminate hepatitis C.

The antibody test, a rapid diagnostic developed by Abbott Laboratories that requires a simple, single finger prick, takes five minutes to complete and cost Egyptians a mere 50¢. Genome tests developed by Roche, which were administered to nearly four million, cost no more than $5 each. That’s a sharp contrast to what people are charging today to test for COVID-19—in some cases $10 to $20 for a serology test, and more than $100 for a genome test.

Because testing and diagnosis leads to treatment for some, the expenses of both are intertwined—a factor the program took into account when calculating opportunities for cost reduction. The three month hepatitis C treatment offered to Egyptians who tested positive was only $45. Compare that number to the $85,000 Americans must pay for the same care regimen, and the danger of leaving COVID-19 testing and medication prices unregulated becomes all the clearer. We cannot afford to see that discrepancy replicated today.

To prevent companies from profiting at the expense of others, three things must happen. First, governments around the world should agree to procure these tests at a cost that everyone, low income countries included, can afford. This will entail the same level of international coordination that is already being used to facilitate the sharing of medical equipment and protective gear across borders. To this end, the World Health Organization has already called for patent pooling on COVID-19 related products.

Second, the United States Congress should ensure that each and every American has access to, and can afford, a test for COVID-19. Testing for infection and immunity is as important to protecting American livelihoods as the stimulus checks due to reach 175 million within the next week. Regulating the costs of COVID-19 tests would be consistent with the goals of some of the bipartisan prescription drug legislation already in the works—meaning there is sufficient political will and incentive to act now.

Lastly, we must recognize that making low cost COVID-19 tests available to all is not just an achievable and necessary target, but the right thing to do. At such a critical juncture in the trajectory of the disease, it is unconscionable that some should be profiteering. To control the pandemic, save lives, and put the world’s economy back to work, we need to be able to see the spread of COVID-19 in its entirety. Otherwise, we will all suffer the consequences.

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Originally published on Forbes (April 8, 2020)