Point-of-Care HIV Testing Promising in Pharmacies

OCTOBER 11, 2015
Jeannette Y. Wick, RPh, MBA, FASCP
Did you know that the 14% of undiagnosed HIV patients cause 33% of new infections? This statistic demonstrates how undiagnosed HIV is a public health hazard.

Point-of-care testing at retail pharmacies is poised to reduce the number of undiagnosed HIV patients—and by extension, new infections. These tests take 20 minutes to complete in 1 visit, which is much quicker than the 2-week turnaround needed when sending tests to established laboratories.  

When results are positive, pharmacists can counsel patients and direct them to confirmatory testing to eliminate the possibility of false positive results.

Researchers from the Division of HIV/AIDS Prevention in the US Centers for Disease Control and Prevention (CDC) recently published a study on this topic in the September/October issue of the Journal of the American Pharmacists Association.

They trained 22 staff members at 21 retail pharmacies on point-of-care HIV testing, specifically the OraQuick ADVANCE Rapid HIV-1/2 Antibody Test. The study included urban and rural pharmacies of all types: for-profit, nonprofit, sole proprietorship, corporate, public, and private.

Pharmacists administered 939 HIV tests over approximately 1 year with pre- and post-testing counseling, and then recorded time spent and related costs. Seventeen of their patients tested positive.
The cost of point-of-care HIV testing averaged $47.21, comparable to the $40 home test kit.

Labor was the primary cost driver (two-thirds of total cost), but ideally in the future, insurers would reimburse pharmacists for their time, similar to vaccination.

Non-labor costs included test kits ($11 per test), control kit reagents, shipping costs, supplies (eg, gloves, biohazard bags, disposable pads), and advertising.

The researchers indicated that an economy of scale exists for point-of-care HIV testing because as the number of patients tested increases, the cost of pharmacist training per patient diminishes.

Point-of-care testing is superior to home testing at a comparable cost because it allows immediate in-person counseling from a health care expert and can reduce the number of undiagnosed and new HIV infections.

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