Single and duplicate, and concurrent and reflex testing strategies

Irina A Tikhonova; Huiqin Yang; Segun Bello; Andrew Salmon; Sophie Robinson; Mohsen Rezaei Hemami; Sophie Dodman; Andriy Kharechko; Richard C Haigh; Meghna Jani; Timothy J McDonald; Martin Hoyle

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Tikhonova IA, Yang H, Bello S, et al. Enzyme-linked immunosorbent assays for monitoring TNF-alpha inhibitors and antibody levels in people with rheumatoid arthritis: a systematic review and economic evaluation. Southampton (UK): NIHR Journals Library; 2021 Feb. (Health Technology Assessment, No. 25.8.)

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Enzyme-linked immunosorbent assays for monitoring TNF-alpha inhibitors and antibody levels in people with rheumatoid arthritis: a systematic review and economic evaluation.

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Appendix 17Single and duplicate, and concurrent and reflex testing strategies

TABLE 61

Cost of testing

Strategy	Phlebotomy appointment (yes/no)		Proportion of patients tested (%)		Cost of a telephone call (£)	Postage (£)	Total cost (per patient) (£)
Strategy	Initial^a	Additional^b	Trough level	Ab level	Cost of a telephone call (£)	Postage (£)	Duplicate	Single
Concurrent	Yes	No	100	100	NA	4	159.06	141.66^c
Reflex	Yes	No	100	4.7^d	3.47	4	141.38	132.27
Reflex	Yes	No	100	35.8^e	3.47	4	148.31	136.49
Concurrent	No	No	100	100	NA	4	51.23	33.83
Reflex	No	No	100	4.7^d	3.47	4	33.54	24.43
Reflex	No	No	100	35.8^e	3.47	4	40.47	28.66

: Ab, antibody; NA, not applicable.
a: A phlebotomy appointment to collect a trough sample.
b: A phlebotomy appointment to collect a trough sample for antibody testing.
c: Cost assumed in the primary analyses.
d: Based on Chen et al.⁹⁴
e: Based on Laine et al.⁵⁴
: Note
: All costs are in 2017–18 prices. The costs include the postage of £4 (for a small parcel shipped within the UK).

Copyright © Queen’s Printer and Controller of HMSO 2021. This work was produced by Tikhonova et al. under the terms of a commissioning contract issued by the Secretary of State for Health and Social Care. This issue may be freely reproduced for the purposes of private research and study and extracts (or indeed, the full report) may be included in professional journals provided that suitable acknowledgement is made and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should be addressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK.

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Tikhonova IA, Yang H, Bello S, et al. Enzyme-linked immunosorbent assays for monitoring TNF-alpha inhibitors and antibody levels in people with rheumatoid arthritis: a systematic review and economic evaluation. Southampton (UK): NIHR Journals Library; 2021 Feb. (Health Technology Assessment, No. 25.8.) Appendix 17, Single and duplicate, and concurrent and reflex testing strategies.
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Enzyme-linked immunosorbent assays for monitoring TNF-alpha inhibitors and antibody levels in people with rheumatoid arthritis: a systematic review and economic evaluation.

Appendix 17Single and duplicate, and concurrent and reflex testing strategies

TABLE 61

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