Benefits, Risks, and Cost-Effectiveness of Corona Self-Tests from a Consumer's Perspective

Background: The aim of this study is to quantify the health benefits, risks, and cost-effectiveness of corona self-tests from a consumer's perspective in Germany. Methods: The clinical endpoints considered in this analysis are avoided SARS-CoV-2 infections and secondary severe clinical events (death, intensive care unit (ICU) admission, and long COVID syndrome). The study determines the number of self-tests that must be conducted under the current 7-day incidence rate (30 per 100,000) to prevent one infection or severe clinical event. The (testing) costs per avoided clinical event and quality-adjusted life year (QALY) gained are calculated from a consumer perspective. In a sensitivity analysis, the number of unreported cases is calculated considering the infection fatality rate. Results: Disregarding the rate of unreported COVID-19 cases, 13,148 self-tests have to be conducted (over 36 years) in order to avoid one undesirable event (death, intensive care unit stay, or long COVID syndrome). Three quarters of infections are not avoided with direct contact persons but along the chain of infection. The costs per quality-adjusted life year gained from a consumer’s perspective are €22,715. Taking into account the number of unreported cases reduces the number of testing years to prevent one undesirable event to 28. Conclusions: The benefits and cost-effectiveness of self-testing in the general population at a 7-day incidence rate (30 per 100,000) appear to be no more than modest.