Table 1.
Per-test cost of HIV viral load (VL) testing performed as point-of-care (POC) at varying testing volumes and at centralized laboratory facilities in Kenya (2020 USD).
| Cost Category | POC Costs by Clinic Testing Volumes (VL Tests Done per Month) | Centralized Laboratory | ||||
|---|---|---|---|---|---|---|
| 20 | 50 | 100 | 200 | 500 | ||
| Personnel time for blood draw a | 0.40 | 0.40 | 0.40 | 0.40 | 0.40 | 0.40 |
| Clinical supplies for blood draw | 0.62 | 0.62 | 0.62 | 0.62 | 0.62 | 0.62 |
| Personnel time for lab processing b | 0.64 | 0.64 | 0.64 | 0.64 | 0.64 | 24.63 [11] |
| Training | 4.00 | 1.60 | 0.80 | 0.40 | 0.16 | |
| Start-up lab equipment costs | 34.15 | 13.66 | 6.83 | 3.41 | 1.37 | |
| Electricity needed to run machine | 0.02 | 0.02 | 0.02 | 0.02 | 0.02 | |
| Rental space for machine | 0.20 | 0.08 | 0.04 | 0.02 | 0.01 | |
| Cartridge | 14.90 | 14.90 | 14.90 | 14.90 | 14.90 | |
| Total Cost per Viral Load Test c | ||||||
| POC testing equipment used for VL tests only | 54.93 | 31.92 | 24.25 | 20.41 | 18.12 | 25.65 |
| 75% utilization of POC equipment for VL testing | 46.34 | 28.48 | 22.53 | 19.55 | 17.77 | |
| 50% utilization of POC equipment for VL testing | 37.75 | 25.04 | 20.81 | 18.69 | 17.42 | |
| 25% utilization of POC equipment for VL testing | 29.15 | 21.60 | 19.08 | 17.80 | 17.07 | |
a We estimated that personnel time for blood draw took an average of 5 min, at a nurse’s salary cost of $0.08 per minute. For all costs, we assumed 1% wastage of blood samples. b We estimated personnel time for laboratory processing took an average of 32 min of hands-on work (see Table 4) for a machine that processed 4 samples at once. Therefore, we assumed the personnel time cost for one individual test was 8 min, at a lab technician’s salary cost of $0.08 per minute. c In each of these scenarios, 1-X% of the cost of the POC equipment is assumed to be absorbed by the tuberculosis (TB) programs. X is either 25%, 50%, 75%, or 100% utilization of POC equipment for VL testing.