How much do tampons really cost?

How much do tampons really cost?

The slow ones weigh on the health system between 35 and 89 euros each, and in private clinics the average rate is close to 100 euros. The kits, reagents, machinery and personnel contribute to the final price, plus any profit margin. Quick swabs are a little cheaper

(photo: H Vesna / Pixabay) We are getting more and more swabs, we should be doing more and we don't get enough: the diagnostic rubbing nasopharyngeal test is by far the most talked about ( and the most effective) in assessing a person's positivity to Sars-Cov-2. It is no coincidence that we have gone from a few thousand swabs per day made in March to about 150 thousand in the last few days, probably however insufficient to accurately track how the infection is circulating but also a sign of a considerable effort for our health system.

As we have already told several times here on Wired then, today there are two different types of tampons, identical in the execution on the patient but different in the analysis. A quick or fast one, which consists of an antigen test in search of the specific proteins of the new coronavirus and which results in a matter of minutes, in exchange for a few less guarantees of reliability. And the other traditional or slow, which is based on molecular tests using the PCR technique and directly identifies the viral RNA, with excellent accuracy but also several hours of waiting.

If on the one hand, making more swabs is a necessary strategy to try to monitor the evolution of the epidemic and contain new outbreaks, at the same time the large number of tests performed daily also raises an economic question. Costs that affect the national health system, or even the individual citizen when it is decided to perform the test independently, typically to speed up waiting times. But how much does each pad cost, and why?

From the stick to the doctor

Making economic evaluations on tampons is not easy, for at least two reasons. The first is that the data available to date show that there is a great variability in costs and prices, not only within private healthcare or between private and public, but also between one regional healthcare and another. And the second reason is that when it comes to public sector expenditure, it is difficult to assess all costs as a whole, even including those items of expenditure that fall into different calculations, such as the salaries of healthcare workers.

The best estimate currently available for the public cost of each tampon is 59 euros. This is a value calculated by the High School of Economics and Management of Health Systems (Altems) of the Catholic University of Rome on the basis of the health expenditure incurred by each region, divided by the number of tests actually performed. And in the same survey it is highlighted that there are regions where the tampon apparently costs less (in Basilicata and Calabria it would seem just 35 euros) and others where the price rises, as for the 79 euros of the autonomous province of Trento and 89 euros. of Veneto. In absolute terms, we would have had up to now an outlay for the state coffers in excess of half a billion euros (we were already over 300 million at the beginning of September), and just under another 9 million euros must be added to the current pace of testing. per day . Figures not even very high if we evaluate the importance of tests to try to stem the infection, but with which the state funds (and health care in particular) must still deal.

The cost per tampon is affected by first of all the price of the disposable kit, which includes the stick with which to take the sample, the container in which to store it and (in terms of consumption) the quantity of reagent necessary for the analysis in the case of the Pcr molecular test. For this kit it is estimated a price ranging between 18 and 25 euros, on which the stick affects for just one euro. A series of items must then be added to this essential cost that include the use of the instruments of the micro-biological laboratories necessary for the analysis, the costs for medical personnel and more generally health, laboratory and administrative personnel that must follow the entire supply chain from sampling for reporting and communication of the result, plus any additional costs attributable to the organization and preparation of the whole process.

Far higher, and above all to be paid by the individual citizen, is the price of the same test performed at private facilities. According to the data collected by Altroconsumo in an analysis conducted on over 150 structures in six regions (Campania, Emilia Romagna, Lazio, Lombardy, Piedmont and Veneto) the average cost rises from 59 for the public to 94 euros for the private sector, with a minimum of 65 euros but also tips of 150 or 200 euros per pad. Data also substantially confirmed by, which lowers the minimum record to 60 euros and confirms the maximum close to 200, but also adds that most of the tests are offered at a price close to 100 euros and only exceptionally above 120 .

What changes with rapid antigen tests?

It is easier to clarify what remains the same: a suitably trained person is needed to take the sample from the patient's nose and pharynx, that is, do the tampon. Apart from this aspect, the analysis procedure changes completely, and consequently also the costs. First of all, the equipment necessary for the analysis of the sample are much simpler - they may consist of a portable digital reader - and remain engaged for much less than the hours required for PCR analysis, limited to just a dozen minutes.

All this reduces not only the time needed to have the result, but also the costs. Also in this case there is a strong geographical variability (as well as between public and private), but in short it can be said that it ranges from 22 euros per buffer granted by the Lazio region for its laboratories (with small discounts, in some cases, even down to 20 euros) up to an average for private structures that approximates 50 euros. But for those who want a preferential and priority lane, some structures offer solutions even beyond 100 euros.

There is, however, a downside, which also explains why we cannot say goodbye to tampons analyzed using the classic method . The antigen test, in fact, guarantees lower reliability, therefore the speed and economy are to be exchanged with a more significant probability of having false positives and false negatives. At the moment, conventionally, it has been established that those who test positive for the swab analyzed quickly must then be subjected to a second swab to be analyzed with a molecular technique, in order to confirm or deny the outcome of the first test.

If for public health this means including the subsequent PCR analyzes on those who test positive for the rapid test in the calculation of the costs, in the case of people who turn to private structures it leads to suggesting to obtain preliminary information on further obligations and expenses to be incurred depending on the outcome of the rapid test.

Let's not confuse rapid swabs and serological tests

Finally, a small clarification. In some cases, some confusion is made between antigenic swabs and serological tests, presenting the latter as rapid tests (actually they are very fast, but the lexical overlap can be confusing). Serological tests have a comparable or lower cost than that of swabs with antigenic analysis, even falling below 10 euros, but they have a different purpose because they evaluate the presence of antibodies in the blood and not that of the virus in the oral and nasal cavity . And then, above all, they do not have an individual diagnostic value but are useful for epidemiological investigations.

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