Point of Care Testing Trial Report - Executive Summary
7. What would be the appropriate Medical Benefits Schedule (MBS) fee for the tests selected in the Trial?
Table of contents
- I. Overview
- II. Trial Preparation
III. Key Findings and Conclusions for Key Research Questions- 1. Is it safe to perform PoCT in general pratice?
- 2. Is the effectiveness the same or better than for the same tests using pathology laboratory testing?
- 3. Is it the same or more cost-effective to perform PoCT compared with pathology laboratory testing?
- 4. Are patients and other stakeholders more satisfied with PoCT than with pathology laboratory testing?
- 5. Are there differences between urban, rural and remote geographic regions in any of the parameters measured?
- 6. Would the regulatory environment used for the Trial meet the needs of all the stakeholders if PoCT were to be made more generally available?
- 7. What would be the appropriate Medical Benefits Schedule (MBS) fee for the tests selected in the Trial?
- IV. Evaluation of the POCT Trial Implementation
- V. Overall Conclusions and Summary
a) How the costs of PoC tests vary with volume
An analysis of how the costs of PoCT in general practice vary with volume and how these unit costs compare with unit costs of testing though a pathology laboratory was undertaken.
Unit costs for the four PoC tests were based on data obtained from the Trial and updated to 2008 values using the CPI. Costs were categorised as establishment costs, annual costs, monthly costs and per test costs.
Sensitivity analysis was used to examine the influence of volume on PoCT unit cost.
Key Findings
- the estimated unit cost for PoCT is $20.02 per test for INR, $75.88 per test for HbA1c, $87.80 for urine ACR and $66.84 for lipid studies
- for all tests except INR, the unit costs were much higher in general practice compared with pathology practice
- cost per test varies with volume.
b) Indicative MBS fees for PoC tests used in the Trial
For other pathology tests, an operating margin of 17% is added to the unit cost to determine the MBS fee. On this basis the following MBS fees would apply:
Urine ACR $87.80 unit cost plus 17% = $105.78
HbA1c $75.88 unit cost plus 17% = $91.42
INR $20.02 unit cost plus 17% = $24.12
Lipids $66.84 unit cost plus 17% = $80.53
Any suggested operating margin for potential PoC tests would be subject to further consideration.
Key Conclusions
- the estimated cost per test for PoCT in general practice based on Trial volumes is much higher than the stimated cost for the tests provided through a pathology laboratory
- unless the typical GP can substantially reduce the amount of resources used in PoCT or the volume in routine best practice turns out to be considerably higher or there are other cogent reasons then the fee for PoCT would have to be substantially higher than the fee for an equivalent test performed by a pathology laboratory.
