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Cost for sickle cell disease screening using isoelectric focusing with dried blood spot samples and estimation of price thresholds for a point-of-care test in Uganda

Authors Mvundura M, Kiyaga C, Metzler M, Kamya C, Lim JM, Maiteki-Sebuguzi C, Coffey PS

Received 5 September 2018

Accepted for publication 15 November 2018

Published 5 February 2019 Volume 2019:10 Pages 59—67

DOI https://doi.org/10.2147/JBM.S186528

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Andrew Yee

Peer reviewer comments 5

Editor who approved publication: Dr Martin Bluth


Mercy Mvundura,1 Charles Kiyaga,2 Mutsumi Metzler,1 Carol Kamya,3 Jeanette M Lim,1 Catherine Maiteki-Sebuguzi,4 Patricia S Coffey1

1Devices and Tools Global Program, PATH, Seattle, WA, USA; 2Uganda Central Public Health Laboratory, Ministry of Health, Kampala, Uganda; 3Evaluation Projects, Infectious Diseases Research Collaboration, Kampala, Uganda; 4Independent Consultant, Kampala, Uganda

Background: Early identification through newborn screening is the first step in active management of sickle cell disease (SCD). Uganda currently screens newborns and infants under 2 years for SCD in high HIV-burden districts using isoelectric focusing with dried blood spot samples. Our analysis sought to estimate the costs per child screened for SCD using this method in Uganda and then to use those data to estimate the price threshold for screening with a point-of-care (POC) test.
Methods: We estimated the financial and economic costs per child screened for SCD using data from health facilities and the Central Public Health Laboratory. These costs included sample collection, transportation, and laboratory processing. Price thresholds for a POC test were estimated using two scenarios.
Results: The price threshold of an SCD POC test used for diagnosis would be $3.77 when taking into account only financial costs and $5.14 when taking into account economic costs. Thresholds for a POC test used for screening would be $3.07–$3.51 and $4.38–$5.09, respectively, depending on test specificity.
Conclusion: The price threshold of a POC test for SCD will depend on the assumptions on how it will be used – either as a screening or diagnostic test. If used for screening, test specificity will have significant impact. Results from this type of costing study can allow developers to incorporate quantitatively estimated price thresholds for innovative products into target product profiles early in the product development cycle.

Keywords: point-of-care, sickle cell disease, costing, Uganda, diagnostics, screening


Creative Commons License This work is published by Dove Medical Press Limited, and licensed under a Creative Commons Attribution License. The full terms of the License are available at http://creativecommons.org/licenses/by/4.0/. The license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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