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Rapid home tests for Covid-19 are flying off store shelves across the country and being sold widely online as the delta variant of the coronavirus makes it harder to return to school, work and travel.
But at $ 10 or $ 15 a test, the price is still way too high for regular use by anyone but the wealthy. A family with two school-aged children may need to spend $ 500 or more per month trying to keep their members – and others safe – safe.
For Americans looking for quick answers, the cheapest over-the-counter Covid test is the Abbott Laboratories BinaxNOW two-pack, for $ 23.99. Just behind are Quidel’s QuickVue tests, at $ 15 a piece. However, supplies are dwindling. After a surge in demand, CVS is limiting the number of tests people can buy, and Amazon and Walgreen’s websites were fully booked by Friday afternoon.
President Joe Biden said Thursday he would use the Defense Production Act to make 280 million rapid tests available. The administration has reached a deal with Walmart, Amazon and Kroger to sell tests “up to 35% less” than current retail prices for three months. For those on Medicaid, home testing will be fully covered, Biden said.
An increased supply should help bring prices down. As schools open and much of the country languishes with no restrictions linked to the pandemic, epidemiologists say rapid, large-scale screening – along with vaccination and mask-wearing – is essential to control the spread of the disease. the delta variant. Yet shortages, little competition, and high, sticky prices mean that routine rapid testing remains out of reach for most people in the United States, even as prices drop 35%.
Consumers elsewhere have much cheaper – or free – options. In Germany, grocery stores sell rapid tests for less than $ 1 each. In India, they are around $ 3.50. The UK offers 14 free tests per person. Canada distributes free rapid tests to businesses.
Michael Mina, assistant professor of epidemiology at Harvard University, praised Biden’s announcement on Twitter while saying he has “some reservations” about its magnitude, and noted that 280 million tests represent “less than one test per person in a year”.
Representative Kim Schrier, D-Wash., Has been advocating for low-cost rapid testing for months. “In an ideal world, a test would either be free or cost less than a dollar so people could take it a few times a week every day,” she said ahead of Biden’s announcement.
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Biden’s initiative “is a good start” for broader rapid testing, Schrier said Friday. “But there is a lot more to do and it needs to be done quickly to use this really important tool in the fight against this virus.”
A national survey released in February by Hart Research and the Harvard TH Chan School of Public Health found that 79% of adults would test themselves regularly at home if rapid tests cost a dollar. But only a third would if the cost was $ 25.
Billions of taxpayer dollars have been invested in products. Abbott Laboratories, for example, cashed hundreds of millions of dollars in federal contracts and made big payments to shareholders last year, increasing its quarterly dividend by 25%. Even so, according to a New York Times investigation, as demand for rapid tests exploded in early summer, Abbott destroyed its supplies and laid off the workers who made them.
Over a year ago, Abbott said it would wholesale BinaxNOW for $ 5 a test to healthcare providers, but that option is not available over the counter to the public. Even with the expected price drop, a two-pack will cost over $ 15. Abbott did not comment further.
Schrier said in the spring that the prices for the tests were high because “the big companies buy all the supplies.” In addition, “their profit is much higher by performing 1,000 tests at $ 30 than 30,000 tests at $ 1” – in other words, they can earn the same amount of money for a lot less tests.
In March, the Biden administration allocated $ 10 billion under the American Rescue Plan Act to test for Covid-19 in schools, leaving the deployment largely to states. This followed the $ 760 million spent by the Trump administration to purchase 150 million Abbott rapid response antigen tests, many of which went to schools. The deployment has been mixed, with states like Missouri mired in logistical challenges.
Schrier wrote a letter late last month asking four federal agencies to update their distribution plans. She also urged the government to increase spending on rapid tests, saying “time is running out” as children return to school.
Related: Unvaccinated People 11 Times More Likely To Die From Covid, Compared To People With A Vaccine.
Antigen testing can give real-time information to people exposed to the virus, said Dr. Dara Kass, associate professor of emergency medicine at Columbia University Medical Center. While awaiting lab results from the polymerase chain reaction, or PCR, testing can take days, and appointments in many states – especially in the hard-hit South – fill up days in advance. . Home collection kits for PCR testing can cost over $ 100.
Rapid tests take less than 15 minutes to detect Covid-19 by locating proteins called antigens. The tests are similar to pregnancy tests, showing one or two lines, depending on the results.
The Centers for Disease Control and Prevention recommends that fully vaccinated people exposed to the virus wear masks indoors for two weeks and get tested three to five days after exposure. Unvaccinated people should be quarantined for 14 days. But that leaves a gray area for those vaccinated hoping to attend classes or go about their business, Kass said.
“Rapid tests give information that allows someone to safely engage in society,” she said. People can follow up with PCR tests, which are more sensitive, to confirm the diagnoses.
In Massachusetts, for example, a “Test and Stay” strategy allows students exposed to the virus to stay in school: students take BinaxNOW tests five days in a row after close contact with infected people.
More than 30 antigen tests have been developed in the United States, but only six companies have Food and Drug Administration clearance for over-the-counter use. No rapid test has full FDA approval. Two rapid molecular options, manufactured by Lucira Health and Cue Health, also have emergency use authorization.
“Unfortunately, many submissions are incomplete or contain insufficient information for the FDA to determine that they meet the statutory criteria,” said FDA spokesperson James McKinney.
The agency has taken a stricter stance than its European counterparts. In June, the FDA warned people to stop using Innova Medical Group’s rapid antigen test, saying the agency had “serious concerns that the test was not performing sufficiently. established “. Yet in the UK, which has multibillion-dollar contracts with the California-based company, the regulatory agency has approved the product.
In Germany, regulators have granted special permission for dozens of antigen tests.
“As long as these tests are regulated as medical devices, the FDA must regulate them not as essential public health tools, but as medical tools, with all the expensive clinical trials slowing everything down by 100” , he added. Mina said on Twitter.
Businesses can’t keep up with demand
With only a handful of rapid tests on the market, it’s harder for companies that haven’t yet obtained FDA clearance to catch up and, in turn, drive prices down, Michael said. Greeley, co-founder and general partner of Flare. Capital Partners, a healthcare technology-focused venture capital firm. “If we are talking about people who test their children every day to go to school,” he said, “for many families the current costs are a real burden.”
The wide-scale adoption of rapid tests seems premature, he said, even with a massive purchase of tests by the US government: “We can’t even get people to floss, so the idea that people will now start rapid tests as their standard operating procedure is a mistaken assumption.
Either way, businesses can’t keep up with the demand.
Ellume said use of his tests increased 900% over the past month. Its rapid home test costs up to $ 38.99. On Walmart’s website, it was listed at $ 26.10 on Friday, but it was out of stock.
The Australian manufacturer secured $ 232 million from the Department of Defense in February to ramp up production after the FDA cleared its home use late last year. But the federal Health Care Improvement Act, which provided the funding, does not limit the prices. Ellume said she would begin production at a factory in Frederick, Md., This fall. At the moment, it is shipping tests from Australia.
This summer, Lucira Health stopped selling its roughly $ 50 rapid molecular test online to focus on larger customers, including the Olympics and the Chase Center in San Francisco, home of the Golden State Warriors, Dan said. George, Lucira’s CFO, in a recent earnings call. .
The company said it was still losing money as it ramped up production, but hoped to start selling directly through its website and Amazon again this year.
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