{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T22:58:14Z","timestamp":1785797894159,"version":"3.56.0"},"reference-count":18,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T00:00:00Z","timestamp":1713312000000},"content-version":"unspecified","delay-in-days":16,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"KfW Group","award":["KfW-TBBU02"],"award-info":[{"award-number":["KfW-TBBU02"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,4,3]]},"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Diagnostic testing is an important tool to combat the COVID-19 pandemic, yet access to and uptake of testing vary widely 3 years into the pandemic. The WHO recommends the use of COVID-19 self-testing as an option to help expand testing access. We aimed to calculate the cost of providing COVID-19 self-testing across countries and distribution modalities.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>We estimated economic costs from the provider perspective to calculate the total cost and the cost per self-test kit distributed for three scenarios that differed by costing period (pilot, annual), the number of tests distributed (actual, planned, scaled assuming an epidemic peak) and self-test kit costs (pilot purchase price, 50% reduction).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>We used data collected between August and December 2022 in Brazil, Georgia, Malaysia, Ethiopia and the Philippines from pilot implementation studies designed to provide COVID-19 self-tests in a variety of settings\u2014namely, workplace and healthcare facilities.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Across all five countries, 173\u2009000 kits were distributed during pilot implementation with the cost\/test distributed ranging from $2.44 to $12.78. The cost\/self-test kit distributed was lowest in the scenario that assumed implementation over a longer period (year), with higher test demand (peak) and a test kit price reduction of 50% ($1.04\u20133.07). Across all countries and scenarios, test procurement occupied the greatest proportion of costs: 58\u201387% for countries with off-site self-testing (outside the workplace, for example, home) and 15\u201350% for countries with on-site self-testing (at the workplace). Staffing was the next key cost driver, particularly for distribution modalities that had on-site self-testing (29\u201335%) versus off-site self-testing (7\u201327%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our results indicate that it is likely to cost between $2.44 and $12.78 per test to distribute COVID-19 self-tests across common settings in five heterogeneous countries. Cost-effectiveness analyses using these results will allow policymakers to make informed decisions on optimally scaling up COVID-19 self-test distribution programmes across diverse settings and evolving needs.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-078852","type":"journal-article","created":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T12:51:43Z","timestamp":1713358303000},"page":"e078852","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Cost of SARS-CoV-2 self-test distribution programmes by different modalities: a micro-costing study in five countries (Brazil, Georgia, Malaysia, Ethiopia and the Philippines)"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0003-7179","authenticated-orcid":false,"given":"Megan A","family":"Hansen","sequence":"first","affiliation":[{"name":"Department of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"},{"name":"Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nkgomeleng A","family":"Lekodeba","sequence":"additional","affiliation":[{"name":"Health Economics and Epidemiology Research Office, Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8873-6669","authenticated-orcid":false,"given":"Joshua M","family":"Chevalier","sequence":"additional","affiliation":[{"name":"Department of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"},{"name":"Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3773-3286","authenticated-orcid":false,"given":"Tom","family":"Ockhuisen","sequence":"additional","affiliation":[{"name":"Department of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"del Rey-Puech","sequence":"additional","affiliation":[{"name":"FIND, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Marban-Castro","sequence":"additional","affiliation":[{"name":"FIND, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo Zohar","family":"Mart\u00ednez-P\u00e9rez","sequence":"additional","affiliation":[{"name":"FIND, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1569-8758","authenticated-orcid":false,"given":"Sonjelle","family":"Shilton","sequence":"additional","affiliation":[{"name":"FIND, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Radzi Abu Hassan","sequence":"additional","affiliation":[{"name":"Clinical Research Center, Hospital Sultanah Bahiyah, Alor Setar, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9337-1908","authenticated-orcid":false,"given":"Vladimir","family":"Getia","sequence":"additional","affiliation":[{"name":"Lugar Research Center, National Center for Disease Control and Public Health, Tbilisi, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catiuscia","family":"Weinert-Mizuschima","sequence":"additional","affiliation":[{"name":"LIFEMED, Pelotas, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Isabelle","family":"Tenorio Bezerra","sequence":"additional","affiliation":[{"name":"Secretaria Municipal de Sa\u00fade, Afogados da Ingazeira, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lensa","family":"Chala","sequence":"additional","affiliation":[{"name":"KNCV Tuberculosis Foundation, Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Leong","sequence":"additional","affiliation":[{"name":"KNCV Tuberculosis Foundation, Manila, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Remilekun","family":"Peregino","sequence":"additional","affiliation":[{"name":"The Aurum Institute for Health Research, Accra, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Keller","sequence":"additional","affiliation":[{"name":"KNCV Tuberculosis Foundation, Den Haag, The 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